HomeMy WebLinkAbout217527 02/25/2013 CITY OF CARMEL, INDIANA VENDOR: 362876 Page 1 of 1
ONE CIVIC SQUARE TRAVELERS CHECK AMOUNT: $323.40
CARMEL, INDIANA 46032 13607 COLLECTIONS CENTER DRIVE
CHICAGO IL 60693 CHECK NUMBER: 217527
CHECK DATE: 2/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 430326 323 .40 GENERAL INSURANCE
TRAVELERS JW PAGE 1
14N99887-ZPP 5216X7087 01/31/2013 000430326 02/15/2013 323.40
<<e CURRENT
CLAIM#: EWP1036 DATE OF LOSS: 04/26/2012
DESCRIPTION: C - LANNAN, REBECCA EEOC CHARGE OF RETALIATION AND
DISABILITY DISCRIMI
CLAIMANT: REBECCA LANNAN
EXPENSE 323.40
CLAIM TOTAL 323.40
CURRENT CHARGES $323.40
ACCOUNT SUMMARY
CURRENT CHARGES 323.40 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 323.40
DISPUTED ITEMS 0.00
ACCOUNT BALANCE 323.40
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
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FEB 2 5 2013
By
TRAVELERS
NON-FUNDED DEPARTMENT
ONE TOWER SQUARE -9MN
HARTFORD, CT 06183
00810 39148
CITY OF CARMEL, CARMEL CLAY PARKS BUIL
ONE CIVIC SQUARE
CARMEL IN 46032
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Travelers
IN SUM OF $
13607 Collections Center Drive
Chicage, IL 60693
$323.40
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept.1 INVOICE NO. ACCT#/TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
1205 000430326 43-475.00 $323.40
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
Mond, February 25, 2013
i
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))
01/31113 000430326 $323.40
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