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Home My WebLink About211075 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 362876 Page 1 of 1 ONE CIVIC SQUARE TRAVELERS h CARMEL, INDIANA 46032 CHECK AMOUNT: $3,911.77 13607 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CHECK NUMBER: 211075 CHECK DATE: 7/17/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4347500 000413779 3 , 291 . 37 GENERAL INSURANCE 1205 4347500 000414217 578 . 10 GENERAL INSURANCE 1205 4347500 000415354 42 .30 GENERAL INSURANCE TRAVELERS PAGE 1 GP09313908 521GX7087 06/29/2012 000413779 07/15/2012 3,291 .37 CURRENT CLAIM#: CES6844 DATE OF LOSS: 06/13/2010 DESCRIPTION: C - ROBERTS, MARY TORT NOTICE ALLEDGING BATTERY, TRESPASS, FALSE ARR CLAIMANT: BILLYJOE ROBERTS EXPENSE 2,805.37 CLAIM TOTAL 2,805.37 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 42.30 C-�RD CLAIM TOTAL 42.30 CLAIM#: ESA6198 DATE OF LOSS: 09/08/2009 DESCRIPTION: CLAIMANT ALLEGES HIS RIGHTS WERE VIOLATED B n�) OF CARMEL POLICE CLAIMANT: DENNIS W CARLYLE D EXPENSE 443.70 CLAIM TOTAL 443.70 CURRENT CHARGES $3,291 .37 ACCOUNT SUMMARY CURRENT CHARGES 3,291 .37 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000 TOTAL DUE 3.291.37 DISPUTED ITEMS 0.00 ACCOUNT BALANCE 3,291 .37 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 00919 39037 CITY OF CARMEL; CARMEL CLAY PARKS ATTN: JIM SPELBRING ONE CIVIC SQUARE CARMEL IN 46032 m 0 m m v 0 0 0 0 a 0 N Alftk TRAVELC®S I PAGE 1 1 1 1 1 1 1 14N99887-ZPP 521GX7087 06/29/2012 000414217 07/15/2012 578. 10 CURRENT CLAIM#: ESM3927 DATE OF LOSS: 02/08/2012 DESCRIPTION: C - KIRBY, KURT EEOC COMPLAINT ALLEGING DISCRIMINATION DUETO A DISABIL CLAIMANT: KURT J KIRBY /� EXPENSE X28.2200 � / ��'<<2- CLAIM TOTAL 28.20' CLAIM#: ETH9758 DATE OF LOSS: 02/11/2012 DESCRIPTION: C- WAKLEY, VICTO V CITY OF CARMEL (COUNTER CLAIM DEFENDANT) CLMT IS AS CLAIMANT: VICTOR D WAKLEY EXPENSE 54'9-, C, CLAIM TOTAL "'-- 90") CURRENT CHARGES $578. 10 ACCOUNT_SUMMARY CURRENT CHARGES 578. 10 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN PAST DUE CHARGES 0.00 AGENT NAME: HYLANT GROUP INC UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000 TOTAL DUE 578. 10 DISPUTED ITEMS 0.00 ACCOUNT BALANCE 578. 10 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 pQa JUL 16 2012 By TRAVELERS NON-FUNDED DEPARTMENT ONE TOWER SQUARE -9MN HARTFORD, CT 06183 00921 39035 CITY OF CARMEL, CARMEL CLAY PARKS BUIL ONE CIVIC SQUARE CARMEL IN 46032 0 a a 0 0 0 Q 0 N AOW TRAVELERS J PAGE 1 THIS ACCOUNT IS SCHEDULED TO GO TO A COLLECTION AGENCY IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE DUE DATE. GP09315757 5216X7087 06/29/2012 000415354 07/15/2012 4,491 . 13 C> P,�•�« 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 C:4:2 2.30' R 5-A1<5 CLAIM TOTAL CLAIM##: EQR4757 DATE OF LOSS: 06/13/2011 DESCRIPTION: C - MYERS, TERRY ALLEGATION OF DISCRIMINATION DUE TO AGE. EEOC COMPLAI CLAIMANT: TERRY D MYERS EXPENSE 2,311 .23 CLAIM TOTAL 2,311.23 CURRENT CHARGES $2,353.53 ACCOUNT SUMMARY CURRENT CHARGES 2,353.53 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN PAST DUE CHARGES 2, 137.60 AGENT NAME: HYLANT GROUP INC UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000 TOTAL DUE 4.491. 13 DISPUTED ITEMS 0.00 ACCOUNT BALANCE 4,491 . 13 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 D Q JUL 16 2012 , By TRAVELERS NON-FUNDED DEPARTMENT ONE TOWER SQUARE -9MN HARTFORD, CT 06183 00920 39036 CITY OF CARMEL, CARMEL CLAY PARKS BUILD ONE CIVIC SQUARE CARMEL IN 46032 0 0 0 0 N O Q O O VOUCHER NO. WARRANT NO. ALLOWED 20 Travelers IN SUM OF $ 13607 Collections Center Drive Chicage, IL 60693 $3,911.77 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 000413779 43-475.00 $3,291.37 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1205 000414217 43-475.00 $578.10 materials or services itemized thereon for 1205 1 000415354 1 43-475.00 $42.30_ which charge is made were ordered and received except Monday, July 16, 2012 Director, dministrati n 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)) 06/29/12 000413779 $3,291.37 06/29/12 000414217 $578.10 06/29/12 000415354 $42.30 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