HomeMy WebLinkAbout305054 11/14/16 CITY OF CARMEL, INDIANA VENDOR: 146500
ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CHECK AMOUNT: $"•`•5,925.18•
CARMEL, INDIANA 46032 DEVELOPMENT ATTN:ACCT RECV CHECK NUMBER: 305054
ty�roN _' 10 N SENATE AVE CHECK DATE: 11/14/16
INDIANAPOLIS IN 46204-2277
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4110000 110116 5,925.18 FULL TIME REGULAR
Prescribed by State Board of accounts City Form No.201 (Rev.1995)
VOUCHER.NO. WARRANT NO. .
ALLOWED 20 .. . .
INDIANA DEPT OF.'WORKFORCE . . . . . .
ACCOUNTS.PAYABLE VOUCHER
DEVELOPMENT ATTN'ACCT RECV IN SUM ol=,$ CITY OF CARMEL
10'N SENATE AVE, An invoice ce or bill to be properly itemized mus's ow kind of sena'ce,where performed,:dates service
INDIANAPOLIS, IN 46204-2277 rendered;by whom,rates'perday,number of hours,rate per hour,number of units,price'per unit,etc. .
$5,925.18 a e
ON ACCOUNT OF APPROPRIATION FOR Purch er
ase Ord # ..
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
110116 41-100.00 $5,925.18 I hereby certify that the attached invoice(s),or 11/1/16 110116 „ Benefit Charges $5,925.18
1701 . : 101 1709: .101
bill(s).is(are)true and correct and that the
materials or.services itemized thereon for
whichr charge is made were ordered and
received except
Wednesday; November09,2016
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
�l�'m State Form 43191(1112/7-08),DWD 1067
ai M
INDIANAPOLIS,IN 46204-2277
CONFIDENTIAL RECORD PURSUANT TO IC 4-1-6,IC 22-4-19-6 001067011
X616
ormoupI i nk
11/01/2016 ,ploymenrpmgrams
823202791001067011 Set:1029 of 1095
CITY OF CARMEL REIMBURSABLE BILL
ONE CIVIC SQ Account Number: 133438
CARMEL IN 46032-2584 PAYMENT DUE DATE: 11/30/2016
AMOUNT DUE:$5,925.18
L41 loo VO
„K..., Please tear at line below and return top portion with your check or make payment at our website
upllnk.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: - - -- - - - - ------------ --------Activity Summary Benefit Charges Interest Penalty Total Liability for Period
------------------------------------------------------------------------------- 6.-66-------------------------------------------------
o
10/2016 Previous Balance $0.00 $0.00 $0.00 $0.00
10/2016 Assessment of Benefit Charges $779.73 $0.00 $0.00 $0.00
10/2016 Ending Balance $779.73 $0.00 $0.00 $779.73
0
MonthNear Activity Summary Benefit Charges Interest Penalty Total Liability for Period
-------------------------------------------------------------------------------------------------------------------------------------
6/2016 Previous Balance $0.00 $0.00 $0.00 $0.00
6/2016 Adjustments Of Interest/Penalty $0.00 $0.00 $50.00 $0.00
6/2016 Ending Balance $0.00 $0.00 $50.00 $50.00
--------------------------------
-----------------------------------------------------------------------------------------------------
Month/Year Activity Summary Benefit Charges Interest Penalty Total Liability for Period
-------------------------------------------------------------------------------------------------------------------------------------
8/2016 Previous Balance $3,00345 $30.03 $300.34 $0.00
8/2016 Assessment Of Interest/Penalty $0.00 $30.03 $0.00 $0.00
8/2016 Ending Balance $3,003.45 $60.06 $300.34 $3,363.85
-
---
----- Vjar-------------i--------------------------------------------------------------------------------------------------------
Month/Year Activity Summary Benefit Charges Interest Penalty Total Liability for Period
--------------------------I----------------------------------------------------------------------------------------------------------
9/2016 Previous Balance $l,56000 $0.00 $O.Oo $0.00
9/2016 Assessment Of Interest/Penalty $0.00 $15.60 $156.00 $0.00
9/2016-- - Ending-Balance- $1_,5.60.00 _ $15.60_ $156.00 _ $1,731.60
Ending Balance: $5,925.18
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 11/30/2016. 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 VVK
82320279 (1)
133438 35- 6000972