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Home My WebLink About302021 08/22/16 CITY OF CARMEL, INDIANA VENDOR: 146500 ® } ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CHECK AMOUNT: $"""'1,303.89' i• CARMEL, INDIANA 46032 DEVELOPMENT ATTN:ACCT RECV CHECK NUMBER: 302021 9M�r"os' 'j 10 N SENATE AVE CHECK DATE: 08/22/16 INDIANAPOLIS IN 46204-2277 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4110000 9769740087 1,303.89 FULL TIME REGULAR VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER INDIANA DEPT OF WORKFORCE DEVELOPMENT ATTN: ACCT RECV IN SUM OF$ CITY OF CARMEL 10 N SENATE AVE An invoice or bill to be properly itemized must show:kind of service,where performed,dates service INDIANAPOLIS, IN 46204-2277 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Payee $1,303.89 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Clerk Treasurer Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 9769740087 41-100.00 $1,303.89 1 hereby certify that the attached invoice(s),or 8/11/16 9769740087 $1,303.89 1701 101 1701 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 Monday,August 22, 2016 I hereby certify that the attached invoice(s),or bill (are)true and correct andav audited samei accordance with IC 5-11-10-1. 2( L Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Tri surer i INDIANA DEPARTMENT oFWORKFORCE DEVELOPMENT euue 7w8).mmo1067 1ow.SENATE AVE.osaa (�NU �UN�NN0&N8 �N�NK0�NUN�N0�0 INDIANAPOLIS,/w*o2o*-2en -----' oowpmemrmLRECORD PURSUANT ro/c*'1'o.moa�1o'n [101067011�� ~`� ~ �� K8-��r w��W��v�^�~�000 on`� ^��**°°nt ptowam' D801/2O1G 811935921001067 011 net:577m1133 CITY[)FCARMEL REIMBURSABLE BILL ONE CIVIC SQ Account Number: 1D3488 PAYKAENTDUE D/�E''801�O10 �ARKX�L |N4GO3Q'�584 AMOUNT DUE:$1.308.89 Please tear at line below and return top portion with your check or make payment at our website uplInk.in.gov. If payment Is made bycheck,please include your SUTA account number on the check. The following items apply\oyour benefit charges: -'��-----''-----��-- ................mmary ��----�'---'��--'----��--'-��T��d' _-__"-_ _-_-__-_-_-_---__-_-'_-__-_------____-----'__~-_-_-__-�� -------- - Pn�voua��x� �D.O8 �0{0 �ouo . �[1[ Assessment ufBene[�Ohuq�m $3,120-00 *O.OD $0.00 $$0.00712016 ^ �2018 Payment Adjustment (�1.81�.11) �OJ30 $0.00 $010 � �O1G Ending Balance $1`303.89 $0.80 $0.00 $1.303.89 7/2016 � � 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 agenov�Ym� Please add the collection ugonmv�fee b)your outstanding balance to tax debt and ail ooUectionsfees \nfull,the Department may assess additional interest and penalties. This isyour total |iabi(buPoymantmaUedafter the 2Othofthe month may not bareflected onthis bU[ Please pay this amount no |aderthanO^ 1/2O1O.Additional interest will accrue atorate of 196per month and aone time penalty of 1096 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 81193592 (1)