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Home My WebLink About304448 10/31/16 CITY OF CARMEL, INDIANA VENDOR: 146500 ;g ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CHECK AMOUNT: $"•"'4,936.95' :9 ?� CARMEL, INDIANA 46032 DEVELOPMENT ATTN:ACCT RECV CHECK NUMBER: 304448 10 N SENATE AVE CHECK DATE: 10/31/16 INDIANAPOLIS IN 46204.2277 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4110000 100316 4,936.95 FULL TIME REGULAR scribed Board ounts Form N ev.19 Pre by State of ;City F o:20T(R 95), VOUCHER'NO. WARRANT NO. . ALLOWED 20 .. . . I ACCOUNTS PAYABLE VOUCHER NDIANA:DEPT OF WORKFORCE IN SUM OF$ DEVELOPMENT ATTNI ACCT RECV a a 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. $4,936.95. -.. . . Payee Purchase:Order# .. . . ON ACCOUNT OF,APPROPRIATION:FOR Clerk Treasurer Terms Date Due:' ue • PO# ACCT# DATE. INVOICE# DESCRIPTION DEPT# INVOICE#: .. Fund# :AMOUNT :. Board Members DEPT# FUND# :. (or note attached invoice(s)or.bill(s)) AMOUNT. . 100316 41-100.00 $4,936.95 1 hereby certify that the attached invoice(s),or 10/3/16 100316 Benefit Charges $4,936.95 1701 101 170.1. . 101 bill(s)is(are)true and correct'and that the materials orservices itemized thereon:for which:charge is made were ordered and received exce t Monday,October 24,.2016 77 Linda Harvey Chief Deputy Clerk Treasurer 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 Cost distribution ledger classification if claim paid motor vehicle-highway fund. Clerk-Treasurer INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT ,�� State Form 43191(R2/7.08),DWD 1067 10 N.SENATE AVE.SE 7 INDIANAPOLIS,IN 46204-2277 +y late CONFIDENTIAL RECORD PURSUANT TO IC 4-1-6,IC 22-4-19-6 001067011 Ge. uplink 10/03/2016 818905101001067011 Set:1052 of 1106 CITY OF CARMEL REIMBURSABLE BILL ONE CIVIC SQ - Account Number:133438 CARMEL IN 46032-2584 PAYMENT DUE DATE:.10/31/2016 AMOUNT DUE:$4,936.95 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 by check,please Include your SUTA account number on the check. The following items apply to your benefit charges: ------------------------------------------------------------------------------------------------------------------------------------- MDnth/Year Activity Summary Benefit Charges Interest Penalty Total Liability for Period ------------------------------------------------------------------------------------------------------------------------------------- 8/2016 Previous Balance $3,042.30 $0.00 $O.Oo $0.00 8/2016 Assessment Of Interest/Penalty $0.00 $30.42 $304.23 $0.00 8/2016 Ending Balance $3,042.30 $30.42 $304.23 $3,376.95 0 ---------------------------...---------------------------------------....... --------------------------------------------------------- Month/Year Activity Summary Benefit Charges Interest Penalty Total Liability for Period ------------------------------------------------------------------------------------------------------------------------------------- 9/2016 Previous Balance $0.00 $0.00 $0.00 $0.00 9/2016 Assessment of Benefit Charges $1,560.00 $0.00 $0.00 $0.00 - 9/2016 Ending Balance $1,560.00 $0.00 $0.00 $1,560.00 Ending Balance: $4,936.95 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 fall 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 10/31/2016. Additional interest will accrue at 9 rate of I%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 81890510 (1) 133438 35-6000972 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT State Form 43283(R 17.08) _ a 10 N.SENATE AVE.SE 202 INDIANAPOLIS,IN 46204-2277 *+ CONFIDENTIAL RECORD PURSUANT TO IC 4-1-6,IC 22-4.19.6 043283011 'ail Ge'nUPI ink 09/01/2016 815924101043283011 Set:7499 of 8866 CITY OF CARMEL Account/Location 133438 ONE CIVIC SQ Number CARMEL IN 46032-2584 Reporting Month 8/2016 Net Charges 1$1,525.00 Posting date 09/01/2016 STATEMENT OF BENEFIT CHARGES CONFIDENTIAL RECORDS PURSUANT TO IC 22-4-19-6,IC 4-1-66 The receipt of this statement does not reopen the question of the claimant's eligibility for unemployment insurance since before the payments were made,the employer had the opportunity and the responsibility to report any information which could disqualify the claimant. Social Benefit Year Claim Transaction Paid for Security Employee's Name End Date Level Date Week Ending Acq Amount Charged Number a' THIS IS NOT A BILL OR A REQUEST FOR MONEY DUE TO THE DEPARTMENT. It is a statement of benefit charges made to your account during the reporting month. If you are a Qualifying employer currently electing to be reimbursable, this statement will be followed next month by your invoice (Form 1067). *** New charges for the reporting month 8/2016 `** XXX-XX-4449 LOIS A CRAIG 12/24/2016 UI 08/07/2016 08/06/2016 $390.00 XXX-XX-4449 LOIS A CRAIG 12/24/2016 UI 08/14/2016 08/13/2016 $390.00 XXX-XX-4449 LOIS A CRAIG 12/24/2016 UI 08/21/2016 08/20/2016 $390.00 XXX-XX-4449 LOIS A CRAIG 12/24/2016 UI 08/28/2016 08/27/2016 $390.00 Total New Charges for Reporting Month 8/2016 $1,560.00 *** Reversed charges for the prior month 9/2011 *** XXX-XX-5760 GREG A PARK 02/18/2012 UI 08/15/2016 09/24/2011 $35.00CR Total Reversed Charges/Credits for the Prior Month 9/2011 $35.00CR Total Amount of Net Charges $1,525.00 An (*) in the Acq column denotes a charge resulting from an acquired business. Marion County Toll Free (800) 437-9136. ** END OF BENEFIT CHARGE STATEMENT** 8159241 (1) 133438 35-6000972 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT State Form 43283 tR 17-08) a If. s 10 N.SENATE AVE.SE 202 INDIANAPOLIS,IN 46204-2277 �'' CONFIDENTIAL RECORD PURSUANT TO IC 4-1-6,IC 22-4-19-6 043283011 ' 10wou link 10/03/2016 818810391043283011 Set,3149 of 8063 CITY OF CARMEL Account/Location 133438 ONE CIVIC SQ Number CARMEL IN 46032-2584 Reporting Month 9/2016 Net Charges 1$744.73 Posting date 10/03/2016 STATEMENT OF BENEFIT CHARGES CONFIDENTIAL RECORDS PURSUANT TO IC 22-4-19-6,IC 4-1-66 The receipt of this statement does not reopen the question of the claimant's eligibility for unemployment insurance since before the payments were made,the employer had the opportunity and the responsibility to report any information which- -could disqualify the claimant. Social Benefit Year Claim Transaction Paid for Security Employee's Name End Date Level Date Week Ending Acq Amount Charged-- Number THIS IS NOT A BILL OR A REQUEST FOR MONEY DUE TO THE DEPARTMENT. It is a statement of benefit charges made to your account during the reporting month. If you are a Qualifying employer currently electing to be reimbursable, this statement will be followed next month by your invoice (Form 1067). *** New charges for the reporting month 9/2016*** XXX-XX-4449 LOIS A CRAIG 12/24/2016 UI 09/04/2016 09/03/2016 $390.00 XXX-XX-4449 LOIS A CRAIG 12/24/2016 UI 09/11/2016 09/10/2016 $389.73 Total New Charges for Reporting Month 9/2016 $779.73 *`* Reversed charges for the prior month 9/2011 *** XXX-XX-5760 GREG A PARK 02/18/2012 UI 09/13/2016 09/24/2011 $35.00CR Total Reversed Charges/Credits for the Prior Month 9/2011 $35.00CR Total Amount of Net Charges $744.73 An(*) in the.Acq column denotes,z charge resulting from an acquired business. Marion County Toll Free (800) 437-9136. *` END OF BENEFIT CHARGE STATEMENT*` 81881039 (1) 133438 35- 6000972