HomeMy WebLinkAbout209416 05/23/2012 *f CITY OF CARMEL, INDIANA VENDOR: 362876 Page 1 of 1
y 0 ONE CIVIC SQUARE TRAVELERS CHECK AMOUNT: $8,284.70
;o CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE
CHICAGO IL 60693 CHECK NUMBER: 209416
CHECK DATE: 5/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 00408966 6,193.71 GENERAL INSURANCE
1205 4347500 00409073 1,353.60 GENERAL INSURANCE
1205 4347500 00409372 737.39 GENERAL INSURANCE
ANW
TRAVELERS J PAGE 1
THE TOTAL DUE INCLUDES PAST DUE CHARGES.
PLEASE REVIEW YOUR ACCOUNT IMMEDIATELY.
•1
GPO9315757 521GX7087 04/30/2012 000409073 05/15/2012 3,581.40
CURRENT
CLAIM EPS2377 DATE OF LOSS: 02/19/2011
DESCRIPTION: C- PARK,GREG VS CITY OF CARMEL POLICE MERIT BOARD.
COMPLAINT FILED AGAI
CLAIMANT: GREG PARK
EXPENSE 1,353.60
CLAIM TOTAL 1,353.60
CLAIM EQR4757 DATE OF LOSS: 06/13/2011
DESCRIPTION: C MYERS, TERRY ALLEGATION OF DISCRIMINATION DUE TO
AGE. EEOC COMPLAI
CLAIMANT: TERRY D MYERS
D Q a EXPENSE 888.30
CLAIM TOTAL 888.30
MAY 2 1 2012 CURRENT CHARGES $2,241.90
ACCOUNT SUMMARY
CURRENT CHARGES 2,241.90 B y INSURED NAME: CI Y OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 1,339.50 ANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817 -5000
TOTAL DUE 3.581.40
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 3,581.40
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE EMAIL DEDUCTIBLE- HELPDESK @TRAVELERS.COM OR
CONTACT THE FOLLOWING ACCOUNTING SPECIALIST AT 1- 800 356 -4098 EXT. 08900: ANTONIO CONTRERAS
TRAVELERS
NON- FUNDED DEPARTMENT
ONE TOWER SQUARE -9MN
HARTFORD, CT 06183
39116
CITY OF CARMEL, CARMEL CLAY PARKS BUILD
ONE CIVIC SQUARE
CARMEL IN 46032
z
0
a
a
0
0
0
0
Q
0
AdW
TRAY LERS J PAGE
GP09313908 5216X7087 04/30/2012 000408966 05/15/2012 6,193.71
CURRENT
CLAIM CES6844 DATE OF LOSS: 06/13/2010
DESCRIPTION: C ROBERTS, MARY TORT NOTICE ALLEDGING BATTERY,
TRESPASS, FALSE ARR
CLAIMANT: BILLYJOE ROBERTS
EXPENSE 1,900.91
CLAIM TOTAL 1,900.91
CLAIM EMS6617 DATE OF LOSS: 04/16/2010
DESCRIPTION: TORT NOTICE ARISING OUT OF THE ARREST MADE BY CPD OF
THE CLAIMANT FOR
CLAIMANT: SHARRON ATKINS
EXPENSE 3,827.50
CLAIM TOTAL 3,827.50
CLAIM ENZ9527 DATE OF LOSS: 09/13/2010
DESCRIPTION: TORT CLAIM CLMT ALLEGES SHE VIOLOATION OF PROTECTED
RIGHTS, EMBARRAS
CLAIMANT: JUSTINE ALLEN i
EXPENSE 465.30
CLAIM TOTAL 465.30
MAY 2 1 2012 CURRENT CHARGES $6,193.71
ACCO UNT SUMMARY
CURRENT CHARGES 6,193.71 B INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 0.00 y HYLANT GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817 5000
TOTAL DUE 6,193.71
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 6,193.71
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE EMAIL DEDUCTIBLE- HELPDESK @TRAVELERS.COM OR
CONTACT THE FOLLOWING ACCOUNTING SPECIALIST AT 1- 800 356 -4098 EXT. 08900: ANTONIO CONTRERAS
4
TRAVELERS
NON- FUNDED DEPARTMENT
ONE TOWER SQUARE -9MN
HARTFORD, CT 06183
39117
CITY OF CARMEL; CARMEL CLAY PARKS
ATTN: JIM SPELBRING
ONE CIVIC SQUARE
CARMEL IN 46032
m
0
a
0
0
0
N
O
Q
O
O
AMk
TRAVEL CRS I PAGE 1
THE TOTAL DUE INCLUDES PAST DUE CHARGES.
PLEASE REVIEW YOUR ACCOUNT IMMEDIATELY.
i 3 i s. i i f3ill
14N99887 -ZPP 521GX7087 04/30/2012 000409372 05/15/2012 2,838.29
CURRENT
CLAIM ESM3927 DATE OF LOSS: 02/08/2012
DESCRIPTION: C KIRBY, KURT EEOC COMPLAINT ALLEGING DISCRIMINATION
DUETO A DISABIL
CLAIMANT: KURT J KIRBY D a
EXPENSE 737.39
CLAIM TOTAL 737.39
MAY 2 1 2012 CURRENT CHARGES $737.39
ACCOUNT SUMMARY
CURRENT CHARGES 737.39 Y OF CARMEL,CARMEL CLAY PARKS BUILDIN
PAST DUE CHARGES 2,100.90 AGENT NA T GROUP INC
UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817 -5000
TOTAL DUE 2,838.29
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 2,838.29
CONTACT YOUR AGENT LISTED ABOVE IF YOU HAVE QUESTIONS RELATED TO YOUR POLICY OR COVERAGE.
FOR BILLING QUESTIONS, PLEASE EMAIL DEDUCTIBLE- HELPDESK @TRAVELERS.COM OR
CONTACT THE FOLLOWING ACCOUNTING SPECIALIST AT 1- 800 356 -4098 EXT. 08900: ANTONIO CONTRERAS
TRAVELERS
NON- FUNDED DEPARTMENT
ONE TOWER SQUARE -9MN
HARTFORD, CT 06183
39115
CITY OF CARMEL, CARMEL CLAY PARKS BUIL
ONE CIVIC SQUARE
CARMEL IN 46032
,i
o
N
r
M
O
7
O
O
O
N
O
a
0
0
VOUCH NO. WARRANT N
ALLOWED 20
Travelers
IN SUM OF
13607 Collections Center Drive
Chicage, IL 60693
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 000409372 43- 475.00 $737.39
materials or services itemized thereon for
1205 000409073 43- 475.00• which charge is made were ordered and
1205 000408966 43- 475.00 $6,193.71 received except
Monday, May 21, 2012
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/30/12 000409372 $737.39
04/30/12 000409073 $2,241.90
04/30/12 000408966 $6,193.71
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