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Home My WebLink About257364 04/08/16 4+y�C�gMf a! 4• CITY OF CARMEL, INDIANA VENDOR: 365130 ONE CIVIC SQUARE MARK CROMLICH CHECK AMOUNT: S"""1,076.48• 9\ �q CARMEL, INDIANA 46032 12685 LANTERN RD CHECK NUMBER: 257364 yet Foci 4� FISHERS IN 46038 CHECK DATE: 04/08/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4128000 040616 1,076.48 TUITION REIMBURSEMENT VOUCHER NO. WARRANT NO. ALLOWED 20 MARK CROMLICH 12685 LANTERN RD IN SUM OF$ FISHERS, IN 46038 $1,076.48 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members 0 I 41-280.00 I $1,076.48 1 hereby certify that the attached invoice(s), or 1120 101 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 Tuesday, April 05, 2016 Uzr '-ZS_ David Haboush Fire Chief Cost distribution ledger classification if claim paid motor vehicle highway fund 'rescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL kn invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by vhom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due nvoice Date invoice# Description Amount Dept. Fund# (or note attached invoice(s)or bill(s)) 04/05/16 I 0 I I $1,076.48 1120 101 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 5711-10-1.6 , 20 Clerk-Treasurer City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Headrip or to commencement of course.) Employee Name Mark Cromlich Department Fire SSN Hire Date 06/20/94 Educational Institution* Ball State University Name of Course" BED 616 Research Methods Credit Hours 3 Starting Date of Course(tnonth/day/year) 1/11/16 By signing below, I signify that I understand the following: • The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2-58. • To receive reimbursement for tuition, I must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit an original itemized receipt or other proof of purchase that links these books to this particular course. • If I leave City of Carmel employment sooner than one (1) year after the end of this course, 1 will repay the City in full for its tuition and book reimbursements for this course. • The tax status of reimbursement payments is subject to federal law,which may change from time to time. Mark Cromlich Digitally signed by Mark Cromlich Employee Signature Date:2016.01.05 12:00:00-05'00' Date 1/4/16 Part II (to be completed by Department Head) (Submit to Human Resources) By signing below, I certify that the applicant will have been employed full-time by the City for at least one (l) year prior to the commencement ofa course, and has not been subject to a disciplinary probation, suspension or demotion within 90 days prior to the beginnin=ty The final claim will be paid from my department's budget,subject to the e;Z s Secti n Code.Department Head Signature Date 5 Part III (to be completed by Director of Human Resources) ` Final Approval . /Date / 7J 1 If denied, reason for denial * The tuition reimbursement program covers only full-semester courses offered through a degree-granting institution accredited by the North Central Association of Colleges and Schools or an equivalent regional accreditor. ** An application will not be considered complete unless a course description from the school's literature is attached. - __ __ -B A _L L=- ---5 TATE - Statement bate:- -- --01/16/2016 - Ball State ID: 900973497 - - i1 N I V E R-S I T Y. Previous Balance: $1,290.00 Office of Bursar and Loan Administration Current Balance: $2,580.22 - Muncie,-Indiana 47306=0725 - - -- - 765-285-1643 Due Date: 02/01/2016 www.bsu.edu/bursar • $864.37 • • --$2,580.22 ---- Mark A. Cromiich - 12685 Lantem Rd Fishers, IN 46038-1040 - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - -- - - - - - --- -- - - - - - - - - If you are mailing a payment, include the top portion. Keep the lower portion for your records. DATE STATEMENT ACTIVITY CHARGE CREDIT *BALANCE FORWARD` $1,290.00 - - -- - - 12/14/2015 —- University Techndlogy Fee-- --- -- $52.00 12/14/2015 Tuition Basic Grad $1,158.00 12/14/2015- -University Technology Fee $58.00 12/14/2015 Tuition Basic Grad $1,158.00 12/14/2015 University Technology Fee -$58.00 12/14/2015 Tuition Basic Grad -$1,158.00 12/17/2015 Electronic Textbooks $8De22 12/17/2015 University Technology Fee [$5.8:.,0 12/17/2015 Tuition Basic Grad --9 $e�1158:- 12/18/2015 University Technology Fee -$58.00 12/18/2015 Tuition Basic Grad -$1,158.00 01/05/2016 Electronic Textbooks -$74.00 01/05/2016 University Technology Fee -$52.00 01/05/2016 Tuition Basic Grad -$1,158.00 01/05/2016 Electronic Textbooks $74.00 01/05/2016 University Technology Fee $52.00 01/05/2016 Tuition Basic Grad $1,158.00 *CURRENT BILLED BALANCE* $2,580.22 TOTAL AMOUNT DUE:: $2,580.22 ***TWO PAYMENT OPTIONS***No sign up required,just pay by one of the following options each month: 1)TOTAL AMOUNT DUE-or-2)DEFERMENT AMOUNT*. Your monthly payment will indicate the choice you have made. If paying the DEFERMENT AMOUNT by the Due Date you will incur: 1st Month:$30 DEFERMENT FEE, 2nd Month:$15 DEFERMENT FEE,3rd Month: $15 DEFERMENT FEE. If payment is late or less than the DEFERMENT AMOUNT, a 1% LATE FEE will be assessed on past due current term charges. Be sure your student has given you access to bean Authorized Payer and a Proxy. Authorized Payer allows online eBill access while Ball State's Proxy access allows us to discuss your records on your behalf. Learn more on all of the above information at www. bsu. edu/bursar. If you'd like to mail payment, please use the address above. *DEFERMENT AMOUNT is not offered in the Summer,TOTAL AMOUNT DUE will be your only payment option. Name:Mark A.Cromlich Ball State ID:900973497 Statement Date:01/16/2016 Page 1 of 1 lT Y1 B A L L S TAT E Statement Date: 02/11/2016 U N I V E R S I T Y. Ball State ID: 900973497 Previous Balance: $2,580.22 Office of Bursar and Loan Administration Current Balance: $2,606.02 Muncie, Indiana 47306-0725 765-285-1643 Due Date: 03/01/2016 www.bsu.edu/bursar a m $1,303.01 $2,606.02 Mark A. Cromlich 12685 Lantern Rd Fishers, IN 46038-1040 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - If you are mailing a payment, include the top portion. Keep the lower portion for your records. / *BALANCE FORWARD* $258022Y� 02/04/2016 Late Fee $25.80 *CURRENT BILLED BALANCE* $2,606.02 TOTAL AMOUNT DUE: $2,606.02 ***TWO PAYMENT OPTIONS***No sign up required,just pay by one of the following options each month: 1)TOTAL AMOUNT DUE-or-2)DEFERMENT AMOUNT*. Your monthly payment will indicate the choice you have made. If paying the DEFERMENT AMOUNT by the Due Date you will incur: 1st Month: $30 DEFERMENT FEE,2nd Month: $15 DEFERMENT FEE, 3rd Month: $15 DEFERMENT FEE. If payment is late or less than the DEFERMENT AMOUNT, a 1% LATE FEE will be assessed on past due current term charges. Be sure your student has given you access to bean Authorized Payer and a Proxy. Authorized Payer allows online eBill access while Ball State's Proxy access allows us to discuss your records on your behalf. Learn more on all of the above information at www. bsu. edu/bursar. If you'd like to mail payment, please use the address above. *DEFERMENT AMOUNT is not offered in the Summer,TOTAL AMOUNT DUE will be your only payment option. Name:Mark A.Cromlich Ball State ID:900973497 Statement Date:02/11/2016 Page 1 of 1 CASHNet Page 1 of 1 JR IN DOI I TO a-&- t -me U. n v xermtlw Bursar and Loan Administration - eBill System Receipt Number: 585332 Customer: CROMLICH, MARK BSU ePayment Current Date: 02/25/2016 Description Amount Payment on Account $2,606.02 Total $2,606.02 ----._._... _..........................._...._................................_._..—___ _ ...._..................._......._..............................__........___. -.______....___-_..__......_..._........_... ................. Payment Submitted Amount BSU ePayment ACH $2,606.02 Checking Account XXXXXX2708 Routing # 274070439 BMO HARRIS BANK NA, NAPERVILLE, IL Total $2,606.02 Thank you for the payment. https:Hcommerce.cashnet.com/cashnetg/selfserve/PrintableReceipt.aspx?IXDS=O&Z=PP 2/25/2016 BMO G Harris Bank A part of BMO Financial Group BMO HARRIS BANK N.A. 108637 P.O. BOX 94033 PALATINE, IL 60094-4033 ACCOUNT NUMBER: 0055862708 Statement Period 02/24/16 TO 03/23/16 90 09768 IM0099002900000000 MARK A CROMLICH PAGE 2 OF 3 0 b 2j9 y _s ��.a2 606 .^ DEBITS -- `BA`L'L SATE UNIV E)Ob Page2of 2 Customer Service 1.800.955.7070 Dec.16-Jan.15,2016 31 Days in Billing Cycle www.capitalone.com Platinum MasterCard Account ending in 8373 Credit Limit: $3,500.00 Available Credit: $1,076.97 NEW BALANCE MINIMUM PAYMENT DUE DATE Cash Advance Credit Limit: $1,500.00 $2,423.03 $27.00 Feb 12,2016 Available Credit for Cash Advances: $1,076.97 ;d Transactions New Balance } $3,886.10 = $2,423.03 R i:. i 1= I' 1L 1L I 1 11 JAN,;PAYPAL ;,,NIUERSIT�C902935de7,3=3• _ ,$r391 x 12 JAN ZACKYS HOT DOGSCARMELIN $41.91 d for Mark A Cromlich#8373 $3,886.10 ► Total Transactions This Period $3,886.10 Total Fees This Period $0.00 100 00 00 I Payment Receipt- PayPal Page 1 of 1 University Corporation for Advanced Internet Development dba Internet2 Secure payments by Payment Receipt Transaction time Jan 11,2016 10:24:54 PST Receipt ID 0570-2252-9999-8602 Total $39.50 USD We'll send a confirmation email to mcromlich@gmail.com.This transaction will appear on your statement as PayPal "UNIVERSITYC. Paid to Shipped to University Corporation for Advanced Internet Development Mark Cromlich Internet2 12685 Lantern Rd. Fishers, IN 46038 United States Your shopping cart Description Price Quantity Amount _.................-... - ...... --- ............................_._..-- __............_._-...__._..........................- Courseload Print on Demand Textbook $39.50 1 $39.50 Item total $39.50 __ Tax $0.00 Total $39.50 USD https://www.paypal.com/us/cgi-bin/webscr?cmd=_flow&SES SION=od9zZ 1 wj bKsj x-HYF... 1/11/2016 Catalog Entries Page 1 of 2 BED 616-Research Methods The concepts and methodology used in content area research; introduction to research design, methodology, research limitations, and proposal preparation; analysis of completed research in the content area; determination of needed content-area research at the secondary and postsecondary levels. 3.000 Credit hours 3.000 Lecture hours Levels: Graduate Schedule Types: Lecture https://prodssb.bsu.edu/PROD/bwckctlg.p_display_courses?term in=201520&one_subj=B... 1/5/2016