212626 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 00352999 Page 1 of 1
t, ONE CIVIC SQUARE HYLANT GROUP
CARMEL, INDIANA 46032 P 0 BOX 40925 CHECK AMOUNT: $1,613.00
INDIANAPOLIS IN 46280-5000
CHECK NUMBER: 212626
CHECK DATE: 9/1212012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4347500 802086 575 . 00 GENERAL INSURANCE
1205 4347500 802389 134 . 00 GENERAL INSURANCE
1205 4347500 802390 904 . 00 GENERAL INSURANCE
HYLANT Indianapolis, 46280-0925 Age "
GROUP Local: 317-817-s000
INVOICE # 802390 P g
ACCOUNT NO._a.,[..i�:...:.:"._��':CSR'
CARME80 79 08/28!12
S Package"-:"Commercial.
„".POLIO]'.#.. . . ---._.....,. ':�.."'...E .�:.•.:._. ,.,...
—�� H630581 M4076TIL12
125 :PRODUCER - .......«..........�...�:i:.:7s..i.... __r_...., . .,. ,.. ._..._.�.., -`--
W. Michael Wells
_. EFFECTIVE -._---_..... .F-WIRATIONa;,,.:,?::.... ..__BALANCE DUE
City of Carmel 01/01/12 01101113 05/23/12
"AMOUNT"PAID;,:.:.._:.,.."
Steve Engelking $ 904.00
One Civic Square
Carmel,IN 46032
,.per
j Eff Date.,-,Trn, 'Type`'" Policy# Description z x;, ,, F o" mount',
INVOICE# 802390
01/01/12 +EN PCKG H63058IM4076TIL12 ADD SHAPIRO'S BLDG Travelers Insurance Companies $ 904.00
ADD SHAPIRO'S BLDG$2,250,334;CONTS$750,000
ALLOCATE PREMIUM:CRC
Invoice Balance: $ 904.00
301Pennsylvania Parkway • Suite 201 • P.O.Box 40925 • Indianapolis,IN 46280-0925
Toll Free: 800-678-0361 Local: 317-817-5000 • Fax:317-817-5151
.� :- ft
HYLANT P.O.Box 40926
Indianapolis,IN 46280-0925 INVOICE # 802389 Page-1,:,;.;'.r" "
a GROUP Local:317-817-5000 „ACCOUNTNO..,: ;
CARME80 79 08/28/12
�?S ;Package''-Commercial
�-
"POLICY#
H630581 M4076TIL12
:.PRODUCER. ..M--.�... .....�.....:.......... ...--....__. .__�a.,.;_• ._�,.,... •..__..�...,�...,.:A_-° �...�.H.
W. Michael Wells
.. EFFECTIVE ,,:_.:.-_.- ESP[RATION..._.--- ..,•,BALANCE DUE ON;':,.'..:_-:_,-
._...ate:._..-...
City of Carmel 01/01/12 01101113 06/06/12
ADIOUNTPAID-.-.__-_.,, ...._;„_... :,:1AMOUNT_DUE-'i', ._.-..-...,,'<. 'w.,:.Y..�.«�.....
Steve Engelking $ 134.00
One Civic Square
Carmel,IN 46032
;;a"Eff Date sTrn; Type.,, Polic # ecri
ption , mount
;:.
INVOICE# 802389
01/01/12 +EN PCKG H63058IM4076TIL12 ADD FINE ARTS Travelers Insurance Companies $ 134.00
ADD SUNDANCE SCULPTURE(ON LOAN FROM LURIE GALLERY)$65,000
ALLOCATE PREMIUM: CITY
Invoice Balance: $ 134.00
301 Pennsylvania Parkway • Suite 201 • P.O.Box 40925 • Indianapolis,IN 46280-0925
Toll Free: 800-678-0361 Local: 317-817-5000 • Fax: 317-817-5151
• �� :-
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hylant Group
IN SUM OF $
301 Pennsylvania Parkway, Suite 201
Indianapolis, IN 46280-0925
$1,038.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1205 802390 43-475.00 $904.00 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 802389 43-475.00 $134.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Monda September 10, 2012
Director, Administrati 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))
08/28/12 802390 $904.00
08/28/12 802389 $134.00
1 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
YLANT P.O.Box 40925
_ Indianapolis.IN 46250-0925 I N `�7 O I C �,i # 802086
UGR OUP Local:317-517-5000 , -. -
.ACGOU�I'.YO.. ..CSR. 1: PATE
CARME80 79 !� 08/22/12
PA-ckaae;-:Commercial
POLICY'#':.': . .,
H_6305SIM4076TIL12
�PRovuCEiF'
W.Michael Wells
EFFI;CTI\'E i EXI'MA1110N BALANCE DUE ON
-
01/01/12 01101113 05/16/12
Cite of Cannel ____ --------r—; ------------------------
_ANJOUNTIWD; AMOUNI'DQE
Steve Enuelkin; S 8,209.00
One Civic Square
Carmel,IN 46032
Eff Date Trn Type Policy,# Description AYnount.
INVOICE r,' 8(12086
01/01/12 +EN PCKG H630581M4076TIL12 AMEND PROP SC'H Travelers Insurance Companies S 8,209.00
ADD INDIANA DESIGN CENITER GruviGE-ALLOCATE PREM:CRC aL47o"
d
,/j
��rr ADD CARMEL C'" CENTER GARAGE-ALLOCATE PREM:CRC 56;156
A-DD WAVELOCH FLOW R E-R-(QENTRAL PARK AQUATICS CENTER)ALLOC
ATE PREIvi:PARKS DE $575
�-� Invoice Balance: S 8,209.00
I ly
V r 6
1
AUG 2 4 IZ j
BY:
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P.O.# -- --PorF
G.L.# /091 • q
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Line bescr eA � � ,c
Purchaser Date
Approval Dated is
301 Pennsylvania Park\vay • Suite 201 • P.O.Box 40925 • Indianapolis,IN 46280-0925
Toll Free: 300-675-0361 Local:317-517-5000 • Fax:317-817-5151
• i
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
00352999 Hylant Group Terms
P.O. Box 40925 Date Due
Indianapolis, IN 46280-0925
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
8/22112 802086 Add flow rider $ 575.00
Total $ 575.00
1 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
i
Voucher No. Warrant No.
00352999 Hylant Group Allowed 20
P.O. Box 40925
Indianapolis, IN 46280-0925
In Sum of$
$ 575.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. kCCT#/TITLI AMOUNT Board Members
Dept#
1091 802086 4347500 $ 575.00 1 hereby certify that the attached invoice(s), or
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
6-Sep 2012
Signature
$ 575.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i
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