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Home My WebLink About216339 01/15/2013 CITY OF CARMEL, INDIANA VENDOR: 362876 Page 1 of 1 ONE CIVIC SQUARE TRAVELERS CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $13,535.58 ` CHICAGO IL 60693 CHECK NUMBER: 216339 CHECK DATE: 1/1512013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4351000 421579 1, 481 . 36 AUTO REPAIR & MAINTEN 1205 4347500 427819 7, 607 . 60 GENERAL INSURANCE 1205 4347500 429266 4, 446 . 62 GENERAL INSURANCE 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. 303GP64A-810 5216X7087 12/31/2012 000429266 01/15/2013 5,927.98 CURRENT CLAIM#: CER0592 DATE OF LOSS: 11/19/2012 DESCRIPTION: C - SMITH, CALVIN IV MADE A LEFT TURN ONTO RANGELINE RD AND DID NOT SE CLAIMANT: CALVIN R SMITH LOSS 4,311 .82 �7 1, CLAIM TOTAL 4,311.82 CLAIM#: EVU5942 es� DATE OF LOSS: 11/07/2012 DESCRIPTION: IV WAS STOPPED AND STARTED TO REVERSE WHEN STRUCK OV CLAIMANT: LARRY D HUGHEY LOSS 134.80 CLAIM TOTAL 134.80 CURRENT CHARGES $4,446.62 ACCOUNT SUMMARY CURRENT CHARGES 4,446.62 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PAST DUE CHARGES 1 ,481 .36 AGENT NAME: HYLANT GROUP INC UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000 TOTAL DUE 5,927.98 DISPUTED ITEMS 0.00 ACCOUNT BALANCE 5,927.98 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 Q D � JAN 1 4 2013 i By TRAVELERS NON-FUNDED DEPARTMENT ONE TOWER SQUARE -9MN HARTFORD, CT 06183 00827 39135 CITY OF CARMEL,CARMEL CLAY ONE CIVIC SQUARE CARMEL IN 46032 N m m co N m N a O O O N O Q O N AFJk TRAVELERS J PAGE 1 THE TOTAL DUE INCLUDES PAST DUE CHARGES. PLEASE REVIEW YOUR ACCOUNT IMMEDIATELY. GP09315757 521GX7087 12/31/2012 000427819 01/15/2013 26,615.60 �> C-/-�lc-_ CURRENT CLAIM#: CES9583 DATE OF LOSS: 10/17/2011 DESCRIPTION: C - CRIDER & CRIDER INC. V HAGERMAN CONST, CITY OF CARMEL, REDEVELOPME CLAIMANT: CRIDER AND CRIDER EXPENSE 18,420.00 CLAIM TOTAL 18,420.00 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 7,607.60 CLAIM TOTAL 7,607. CURRENT CHARGES $26,027.60 ACCOUNT SUMMARY CURRENT CHARGES 26,027.60 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PARKS BUILDIN PAST DUE CHARGES 588.00 AGENT NAME: HYLANT GROUP INC UNAPPLIED PAYMENTS 0.00 AGENT PHONE: (317) 817-5000 TOTAL DUE 26.615.60 DISPUTED ITEMS 0.00 ACCOUNT BALANCE 26,615.60 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 JAN 14 2013 5 By TRAVELERS NON-FUNDED DEPARTMENT ONE TOWER SQUARE -9MN HARTFORD, CT 06183 00826 39136 CITY OF CARMEL, CARMEL CLAY PARKS BUILD ONE CIVIC SQUARE CARMEL IN 46032 m m 0 n N a 0 0 0 0 a 0 0 VOUCHER NO. WARRANT NO. ALLOWED 20 Travelers IN SUM OF $ 13607 Collections Center Drive Chicage, IL 60693 $12,054.22 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 000429266 43-475.00 $4,446.62 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1205 000427819 43-475.00 $7,607.60 materials or services itemized thereon for which charge is made were ordered and received except Monday, January 14, 2013 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)) 12/31/12 000429266 $4,446.62 12/31/12 000427819 $7,607.60 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 Non-Funded Deductible Collections& Billing System Page 1 of 1 TRAVELERSI DEDUCTIBLE / SELF-INSURED INVOICE (copy) POLICY NUMBER ACCOUNT NUMBER BILL DATE BILL NUMBER PAYMENT DUE TOTAL DUE 3036P64A-810 5216X7087 9/28/2012 421579 10/15/2012 $1,780.94 MAIL PAYMENT TO: PAYER ADDRESS: TRAVELERS CITY OF CARMEL,CARMEL CLAY 13607 COLLECTIONS CENTER DRIVE ONE CIVIC SQUARE CHICAGO,IL 60693 CARMEL IN 46032 RETURN THIS PORTION WITH YOUR CHECK MADE PAYABLE TO TRAVELERS. PLEASE WRITE THE POLICY&ACCOUNT NUMBER ON YOUR CHECK. TRAVELERS) THE TOTAL DUE INCLUDES PAST DUE CHARGES. PLEASE REVIEW YOUR ACCOUNT IMMEDIATEUT. POLICY NUMBER ACCOUNT NUMBER BILL DATE BILL NUMBER PAYMENT DUE TOTAL DUE 3036P64A-810 5216X7087 9/28/2012 421579 10/15/2012 $1,780.94 CURRENT CLAIM#:EUY7509 DATE OF LOSS:09/12/2012 DESCRIPTION: AARON LEACH OFFICE AARON LEACH WAS BACKING OUT OF HIS GARAGE IN HIS PO CLAIMANT: AARON LEACH LOSS $1,481.36 CLAIM TOTAL $1,481.36 CURRENT CHARGES $1,481.36 ACCOUNT SUMMARY CURRENT CHARGES $1,481.36 INSURED NAME: CITY OF CARMEL,CARMEL CLAY PAST DUE CHARGES $299.58 AGENT NAME: HYLANT GROUP INC UNAPPLIED PAYMENTS $0.00 AGENT PHONE: (317)817-5000 TOTAL DUE $1,780.94 DISPUTED ITEMS $0.00 ACCOUNT BALANCE $1,780.94 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 http://dedbilling.prodlb.travp.net/WBDI_NONFUNDED NiewBilldtiv4.aspx?bilinum=421... 12/5/2012 VOUCHER NO. WARRANT NO. ALLOWED 20 Travelers IN SUM OF $ 13607 Collections Center Drive Chicago, IL 60693 $1,481.36 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members Prior Yenr I hereby certify that the attached invoice(s), or 1110 421579 I 43-510.00 $1,481.36 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 Monday, January 14, 2013 Chief of Police V 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)) 09/28/12 421579 deductible/car 26-Leach $1,481.36 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