HomeMy WebLinkAbout170704 04/14/2009 CITY OF CARMEL, INDIANA VENDOR: 362747 Page 1 of 1
ONE CIVIC SQUARE TRAVELERS
CHECK AMOUNT: $597.86
CARMEL, INDIANA 46032 CIO MARY COUTURE
+�PSOto PO BOX 3204 CHECK NUMBER: 170704
NAPERVILLE IL 60566
CHECK DATE: 411412009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM OUNT DESC RIPTION T
1110 4351000 597.86 AUTO REPAIR MAINTEN
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TRAVELERS)
St. Paul Mercury Insurance Company
P.O. Box 3204
Naperville, IL 60566 -7204
(800)842 -6172
04/02/2009
J /City Of Carmel
One Civic Square
Carmel, IN 46032
I
Insured: City Of Carmel; Carmel Clay Parks
Claim /File 028 AD A412698 T
Date of Loss: 01/22/2009
Policy ZPP 20M0012A
Date Notice Received: 02/18/2009
Reference A4I2698
Dear /City Of Carmel:
Please be advised that we have since received a supplement from our appraiser Bob Ferraro and your shop
Carmel Auto Refinishing advising that there has been a revision in the amount of damages to the 2005
Chevy Impala vin ...9363446 for the above auto accident. This diffrence is the result of a part that was on
national back order that was not able to be received. In turn, the issue was resolved for a lesser amount of
$597.86.
Please forward payment to be returned to us in the amount of $597.86 as soon as possible and be sure and
note the claim of A4I2698 on your payment. Please forward this payment to our office at the following
location:
Travelers Insurance
Attn: Mary Couture
PO Box 3204
Naperville, IL 60566
(630) 961 -8934
We appologize for any inconvenience that this may cause. Thank you for your cooperation.
If you have any questions, please call :ne at the number shown above.
Sincerely,
Mary Couture
Cl Rep
(630)961 -8934
P0990 7/05
„�!°rescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
11
Travelers Insurance Purchase Order No.
�ATTN: MaRY Couture
P.O. Box 3204 Terms
Naperville, IL 60566
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
4/2/09 a ent for difference of repair part check issued 597.86
from insurance company higher than repairs—invoiced
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
t
ALLOWED 20
Y ravelers Insurance IN SUM OF
ATTN: Mary Couture
P.O. Box 3204
N aperville, IL 60566
597.86
ON ACCOUNT OF APPROPRIATION FOR
p olice ge nera l fu
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 510 597.86 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
April 2 2009
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund