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City of Louisville <br />Open Item Listing (Date: 11/29/2007) <br />Status =POSTED <br />Due Date = 11/29/2007 <br />Bank Account =First National Bank of CO-General Operating Account <br />Vendor# Vendor Name Total <br />2000 CIGNA HEALTHCARE OF COLORADO $80,255.57 <br />Invoice# 107-6214 $80,255.57 <br />#7057 DEC07 EMP PREMS 1 @ $80255.57 Each Net Amount = $80,255.57 Tax Amount = $0.00 Total = $80,255.57 <br />010-000-20040.02 Employee Cigtta Deduction Payable $80,255.57 <br />1 115 COLONIAL INSURANCE $239.21 <br />Invoice# I07-6219 $239.21 <br />NOV AND DEC EMP PREMS 1 @ $239.21 Each Net .Amou.nt = $239.21 Tax Amount = $0.00 Total = $239.21 <br />010-000-20090.00 Employee Colonial Ins Deduction $2:39.21 <br />2545 COLORADO CHAPTER ICC $70.00 <br />Invoice# 107-6213 $70.00 <br />ICC COLORADO CHAPTER -ANNUAL BUSINESS MEEiTING - TENNANT/ALLEN 1@ $70.00 Each Net Amount = $70.00 Tax Amount = $0.00 Total = <br />$70.00 <br />O] 0-510-53801.00 Education Expense $70.00 <br />5255 COLORADO FAMILY SUPPORT R $51.04 <br />Invoice# 107-6211 $51.04 <br />EMPLOYEE GARNISHMENT PP#24 1.000 $51.04 Each T1et Amount = $51.04 Tax Amount = $0.00 Total = $51.04 <br />010-000-20092.00 Employee Garnishment Deduction $51.04 <br />11298 DELTA DENTAI:, $10,741.95 <br />Invoice# 107-6217 $10,741.95 <br />#007562 DEC07 EMP PREMS 1 @ $10741.95 Each Net Amount = $10,74] .95 Tax Amount = $0.00 Total = $10,741.95 <br />010-000-20040.03 Employee Delta Deduction Payable $10,741.95 <br />12666 FIDELITY NAT'L TITLE INS CO $605.00 <br />Invoice# 107-6212 $605.00 <br />INSURANCE -COAL CREEK CEMETERY iGA 1 @ $605.00 Each Net Amount = $605.00 Tax Amount = $0.00 Total = $605.00 <br />05 1-463-53 1 00.99 Professional Services-Other $605.00 <br />12667 FIRST NATIONAL BANK $30.00 <br />Invoice# 107-6218 $30.00 <br />HSA ACCOUNT SET UP FEES 1 @ $30.00 Each Net .Amoumt = $30.00 Tax Amount = $0.00 Total = $30.00 <br />O] 0-200-53100.24 Professional Services-Bank Charges `.630.00 <br />7735 JEFFERSON PILOT ]FINANCIAL $5,185.50 <br />Invoice# 107-6215 $5,185.50 <br />05920 O1 DEC07 EMP PREMS 1 @ $5] 85.50 Each Net Amount = $5,185.50 Tax Amount= $0.00 Total = $5,185.50 <br />010-000-20040.04 Employee Jefferson Pilot Deduction Payable $5,185.50 <br />6455 KAISER PERMP,NEIVTE $18,820.81 <br />Invoice# I07-6216 $18,820.81 <br />05920 Ol DEC07 EMP PREMS 1 @ $18820.81 Each Net Amount = $18,820.81 Tax Amount = $0.00 Total = $18,820.81 <br />010-000-20040.01 Employee Kaiser Deduction Payable $18,820.81 <br />$115,999.08 <br />