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232948 05/21/14 Jai CITY OF CARMEL, INDIANA VENDOR: 360074 ® �l ONE CIVIC SQUARE SUE WOLFGANG CHECK AMOUNT: $********95.12* r. ,? CARMEL, INDIANA 46032 C/O HUMAN RESOURCES CHECK NUMBER: 232948 ONE CIVIC SO CHECK DATE: 05121/14 CARMEL IN 46032 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4343002 REIMB 16.00 EXTERNAL TRAINING TRA 1201 4355300 REIMB 79.12 ORGANIZATION & MEMBER Cgp3jE �y�trntRsr�! CITY OF CARMEL Expense Report (required for all travel expenses) —i 111 EMPLOYEE NAME: SUE WOLFGANG DEPARTURE DATE: 5/9/2014 TIME: 7:45 AM/PM DEPARTMENT: HUMAN RESOURCES RETURN DATE: 9-May TIME: 3:00 AM/PM REASON FOR TRAVEL: IMPACT CONFERENCE DESTINATION CITY: INDIANAPOLIS TRAVEL EXPENSES ARE FOR (check all that apply): ADVANCE REIMBURSEMENT XX PER DIEM Date Transportation Gas/Tolls/ Meals Air-fare Car Rental Other Parkin Lodging Misc. Total 9 Breakfast Lunch Dinner Snacks Per Diem 5/9/14 $16.00 $16.00. $0.00 $0.00 $0.00 $0.00 $0.00 $0..00 $0.00 _. $0.00 $0.00 $0.00 $0.00 1 MAY IV ZU14 $0.00 $0.00 $0.0:0 $0.00 $0.00 $0.00 $0.00 $0.00 0.00 Tota I 1 $0.001 $0.001 $0.00 $16.00 $0.001 $0.00 $0.00 $0.001 $0.00 $0.00 $0.00 —$16-010 DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: S (� City of Carmel Form#ER06 Revision Date 5/12/2014 Page 1 IMPACT Spring Conference MaY 9, 2014 IACT Office Building 125 W. Market Street, Indianapolis, IN 46204 AGENDA Friday, MU 9 8:3o a.m. — 8:5o a.m.. Registration . 8:50-a.m..— 9:0o a.m. , Welcome . 9:0o a.m. — 10:3o a.m. Crazy Things That Happen At Work r This workshop will explore some of the strange predicaments that we sometimes find ourselves in by dealing with unusual personnel matters. Kent will use true-to-life scenarios to engage attendees in an interactive discussion about employee overtime, interplay of FMLA and personnel policies, employee complaints, and.discipline. R. Kent Irwin, President Waggoner, Irwin, Scheele&Associates Inc. (WIS) 10:3o a.m. — 10:40 a.m. Break 10:464.,m. — 12:00 p.m. Networking Round Table* Discussions — Onsite Clinics, Wellness Ideas, and,Employee Engagement .. . Hear what other cities and towns provide to employees,what has been successful and hasn't, and hear ways to successfully educate employees about benefits, opportunities, along with creative ways to reward employees so they know they are valued in your organization. Holly Ramon, Noblesville;IMPACT Researcher Ethan Lee, Fishers, IMPACT Secretary �. 12:00 P.M. — 12:45 p.m. Lunch/Network 12:45 p.m. — 1:45 p.m. EEOC—You just received papers from the EEOC— do.you know what to do? A representative will tellus how to respond and also present information on what is a Reasonable Accommodation and Religious Discrimination in today's work environment. Julia Passwater 1:45 p.m. — 2:00 P.M. Closing Remarks/Upcoming Dates/Handouts 2014,IMPACT Spring Meeting SUE ;MPICIT Sue Wolfgang Employee Benefits Adminstrator Carmel Circle Centre Mall Indianapolis; IN Fee CoMputer Number: 13 i Cashier: 165 Id #165 Transp-tion Number: 83979 Enter.,r. 05/09/2014 08:29 Exited: 05/09/2014 14:06 j Ticket #19,1.56 Dispenser 945 Lot: Court St Area: Area'2 Rate: Daly Rate 12-2012 Parking Fee: $ 1F 00 Total Fee: $ 16.00 Cash: $ 20.00 Total Paid: $ 20.00 Change Due $ 4.00 Thank You Denison Parking I i Page 1 of 2 A 1 1(ancan Asso- C.' '. latibn qf Notanes Ord e r.Confirmation Order#: 06-14122673 DATE: 05/07/2014 11:35 AM Customer#: 06-60909 Ship To: Bill To: Susan Wolfgang Susan Wolfgang 168 Aspen Way . 168 Aspen Way Carmel,IN 46032 Carmel,IN 46032 US US Shipping Option: US Postal Service We have assigned you a customer ID#: 06-60909 Order Summary: Item# Item Name Qty. Price/Ea. Total IN205 Notary Self-Inking Stamp (Rectangular) - P40 1 $16.95 $16.95 Notary Name: Susan Wolfgang County Name: Hamilton Commission#: 653373 Expiration Date Imm/ddlyyyy>:05/06/2022 Stamp Case Color: Paprika-Green Ink Color Selected: Black Impression: #1 Subtotal: $16.95 Special Instructions: .......... US Postal Service: $5.95 Discount: -$0.00 Sales Tax: $0.00 Submitted To GRAND TOTAL: $22.90 RECEIVED: $22.90 MAY 19 2014 BALANCE DUE: $0.00 Clerk Treasurer Sales tax in Texas is include( noon CST(except for weekends and holidays)will be shipped the next business day.Allow 2 to 5 regular business days for delivery.By purchasing from https:Hsecure.usnotaries.net/us/print.receipt.asp?receipt=true&ID=122673&CardDigits=***... 5/7/2014 lNallonal 1VULdry 1-1SSUCIal1011: ISCC:U111C a 1V01,dI'y, t-�.CI1CW yUUr INULary comII11551Ur1, notary ... rage 1 of z NAT[t?NAL . NtYi'ARY .,tea A..sc:x:cnrrcuv 1.806.876-6827 BECOME RENEW BECOME BECOME AN 'RESOURCE SHOP: A"TafWyou fi"G b?ff&inc,%VAV&the NNAl4 PVH5FNo£.Ai5T%eeds. We;appreckeegrour buisiness!YoLmorderEhas beSnlNG received. Order Information: Your order'reference number is: 9032299 NNA Member ID: 160146288 Ship to: Bill To Susan Elaine Wolfgang Susan Elaine Wolfgang' ; swolfgang@carmel.in.gov 168 Aspen Way 168 Aspen Way Carmel IN 46032 Carmel IN 46032 Please note: If your order conta'fns membership(s), the NSKCertification'Exam or any online training program,your account may take up to 24 hours to update and allow.access. If your credit card is declined, you will receive notification by mail within 7-1b days. If you have any questions regarding this order, please contact your NNA representative at: 1-800-876-6827 between 500 a.m. and 5:00 p.m., Pacific Time, Monday through Friday. ID Name Price Quantity Extended 92340960005000 IN - Bond 5000 for 8 years $45.00 1 $45.00 Subtotal: $45.00 .., .:.•:..... •, .... ... ,�.. • ,.,,;. ., Shipping: $0.00 Tax: $0.00 Total: $45.00 Due to tax calculations,your order total may vary slightly higher or lower when your order is processed. Shipping Rules &Restrictions • Orders placed after 3:OOPM Pacific Time(Mon-Fri)will be processed the.next business day • Saturday delivery is not available for web orders. Please call Customer Service. Submitted To • Expedited shipment of bonds incur a shipping surcharge. (Two Day: $10.95/Next Day: $1S 95) MAY 19 2014 • Custom items such as stamps and embossers take up to three business days to manufactur after the required documentation is received. Please see the individual item for required documentation details. C' �"� �J rp • Any items ordered with a seal or other custom product will be shipped via your preferred sh ping met'hhoo°d wfien th�e�seaa o`orr�ustolfir product is ready. • For Notary supply packages, all items except the bond, seal and insurance, will ship via your choice of shipping.The stamp, bond, and insurance will be shipped via first class mail when your commission information is received. • Expedited shipping is not available for P.O. Box addresses • Please call Customer Service to verify all Next-Day and 2-Day Air shipments Notary Bond Orders CA, MO: Fax or mail a copy of your Commission Certificate/Letter. FL,TX: No further action is needed.Your bond was executed with your commission application. PA: Fax or mail a copy of your Bond and oath form with commission information. Include the Order and Member/Customer numbers shown at the top of this form.We will forward your bond when we receive this information. DC:a-Mail your bond form and appointment notice to Insurance. Include your Order and Member/Customer numbers shown at the top of this page.We will forward your executed bond when we receive this information. All other states: Contact the Insurance Department at 800-876-6827 for instructions. https://www.nationalnotary.org/cart/submit_cart.html 5/7/2014 Indiana Payment Portal Page 1 of 1 Your transaction is complete Your transaction is complete. Print this receipt for your records. Your receipt identification number is 11606186. Please reference this number in any correspondence regarding your transaction. Payer Information ? SUSAN WOLFGANG 168 ASPEN WAY CARMEL, IN 46032 Phone : 317 - 800 - 0697 Email : swolfgang@carmel.in.gov Account Information ? Transaction Details Unit Extended DescriptionUnitQuantity Price Notary Application Fee $10.00 1 $10.00 Instant Access Fee $1.22 1 $1.22 Total : $11.22 The following amounts have been charged to your credit card. Your credit card statement will show the following merchant name(s) and amount(s) for this transaction. Merchant Amount IN Sec of State 800-236-5446 $11.22 The total amount charged to your credit card is $11.22. Privacy Statement Submitted To MAY 19 2014 Clerk `treasurer https:Hsecure.in.gov/apps/kwikekard/checkout/servlet/receipt?token=F8D2B 50F572216D6... 5/7/2014 sT -t 40. �,�►..-Y �• �� is �''�' `�-:.�+►..1 d� r • � : .� a ��'f f �. •r}. Si Nit. j• n ! : # I m" I x a 0 , Is = R E I„ � m `a �T�I*T I `THE, NA34F..AND BY THE,AUTRO,13IT�'�OF _ T€ E.STATE.Of INDIANA, I DO HERE.BYAPPOINr AND COMISSION, AS N Public COMMISSION NUMBER: 653373 SUSAN ELAINE WOLFGANG 168 ASPEN WAY CARMEL, IN 46032 WITHIN AND FOR THE COUNTY OF HAMILTON AND THE STATE OF INDIANA FROM MAY 7, 2014 UNTIL AND EXPIRING ON MAY 6, 2022 n (Tustimolle Whereof I HAVE HEREUNTO SET MY HAND AND .••' s``. r*`'••, CAUSED TO BE AFFIXED THE SEAL OF � :'` - I -�='% K y •` `s , THE STATE, AT THE CITY OF INDIANAPOLIS, ON MAY 7, 2014 "'" N ` MIKE PENCE - GOVERNOR a • r n1 i� '"""" l' �• h ra •/ e e +a a ••*aa••t*•'tai= 1a � - L Indiana Notary Public Page 1 of 1 Notary Public CONNIE LAWSON Transaction Completes) Log out>> Congratulations! Your application for an Indiana Notary Commission has been filed and approved by the Indiana Secretary of State. You are now a part of the largest single group of public officials in our state, with over 80,000 members. As a notary public, your duties serve a critical function within the state. Notarization is important as an attestation that the signature or signatures on a document have been witnessed, and the parties identified by an impartial public official. Notaries are expected to be impartial, unbiased and without a financial interest in the agreements they notarize. To assist you in rendering professional service, my office maintains a guide outlining the laws governing the official acts of notaries. The information provided in the guide, although a good reference, does not address every question, problem, or situation you might face as a notary. If at any time you are unsure how to proceed, I recommend you seek legal advice; as a notary you may be liable both criminally and civilly for any negligent or fraudulent acts. We want to hear from you! Take this short online survey and tell us about your experience using the online Notary application. For your records your Notary Commission Certificate is available for download. You must have Adobe Reader installed on your computer to open this file. n�wme•ecnot�. A recei t of your transaction is also available for your records. If you need further assistance, please do not hesitate to call my office at(317) 232-6576. We are always available to serve you and the public. Sincerely, d0"X.� ""M Connie Lawson ' (l Indiana Secretary of State Return to Notary Home Page Home I SOS Home I Contact I FAQ I Survey Copyright©2010 by the Indiana Secretary of State.All rights reserved. https://myweb.in.gov/SOS/notaryapp/Common/PrintCommission.aspx 5/7/2014 VOUCHER NO. WARRANT NO. ALLOWED 20 Wolfgang, Sue IN SUM OF$ Employee $95.12 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 06-14122673 43-553.00 $22.90 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1201 9032299 43-553.00 $45.00 materials or services itemized thereon for 1201 11606186 43-553.00 $11.22 which charge is made were ordered and 1201 05.12.14 43-430.02 $16.00 received except Monday, May 19, 2014 Director, HR 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)) 05/07/14 06-14122673 Reimburse Notary Stamp $22.90 05/07/14 9032299 Reimburse Bond $45.00 05/07/14 11606186 Reimburse Notary Application Fee $11.22 05/12/14 05.12.14 Reimburse Parking $16.00 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