HomeMy WebLinkAbout235725 08/13/14 yr_CAq
CITY OF CARMEL, INDIANA VENDOR: 146500 M�,**,
ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CHECK AMOUNT: $ 131.74
f ?�; CARMEL, INDIANA 46032 DEVELOPMENT ATTN:ACCT RECV CHECK NUMBER: 235725
1j�roN�° 10 N SENATE AVE CHECK DATE: 08/13/14
INDIANAPOLIS IN 46204-2277
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 R4110000 36472 676277000 131.74 UNEMPLOYMENT FEES
INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT
d`
State Form 1067(07.08)
10 N.SENATE
INDIANAPOLIS,VN 46204-2277
..._.__F CONFIDENTIAL RECORD PURSUANT TO IC 4-1-6,IC 22-4-19-6 001067011
GelI i nk
08/11/2014
p
ployment programs
712372041001067011 Set:427 of 1028
CARMEL CLAY BOARD OF PARKS AND RECREATION REIMBURSABLE BILL
1411 E 116TH ST Account Number:676277
CARMEL IN 46032-3455 PAYMENT DUE DATE:08/31/2014.
AMOUNT DUE:$131.74
�► Please tear at line below and return top portion with your check or make payment at our website
www.uplink.in.gov.If payment is made by check,please include your SUTA account number on the check.
The following items apply to your benefit charges
-
------------------------------------------------------------------------------------------------------------------------------------
Month/Year Activity Summary Benefit Charges Interest Penalty Total Liability for Period
-------------------------------------------------------------------------------------=----------------------------------------------.
7/2014 Previous Balance $0.00 $0.00 $0.00
7/2014 Assessment of Benefit Charges $131.74
7/2014 Ending Balance $131.74 $0.00 $0.00 . $131.74
0
a Ending Balance: $131.74
0
If the Department has referred your account to a collection agency, please note that the total amount set forth on this
notice does not include the collection agency's fee. Please add the collection agency's fee to your outstanding balance to
satisfy your account. If you fail to pay your tax debt and all collections fees in full, the Department may assess additional
interest and penalties.
This is your total liability. Payment mailed after the 20th of the month may not be reflected on this bill. Please pay this
amount no later than 08/31/2014. Additional interest will accrue at a rate of 1% per month and a one time penalty of 10%
will be assessed on any outstanding benefit charges after the payment due date.
If you have any questions, please call (800) 437-9136 and ask for a Collection representative
FT
d
AUG - 6 2014
]3y:
71237204 (1)
676277 90 - 0629237
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.
146500 Indiana Dept. of Workforce Development Terms
10 North Senate Ave., SE106 Date Due
Indianapolis, IN 46204-2277
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
8/4/14 676277000 Unemployment charges Parks Acct-Assesement JuP14 36472 $ 131.74
Total $ 131.74
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
Voucher No. Warrant No.
146500 Indiana Dept. of Workforce Development Allowed 20
10 North Senate Ave., SE106
Indianapolis, IN 46204-2277
In Sum of.$
$ 131.74
ON ACCOUNT OF APPROPRIATION FOR
101-General Fund
PO#or INVOICE NO. ACCT#/ AMOUNT Board Members
Dept# TITLE �`
36472 676277000 4110000 $ 131.74 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
i
i
7-Aug 2014
Signature
$ 131.74 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund