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HomeMy WebLinkAbout307437 01/20/17 (9, ) CITY OF CARMEL, INDIANA VENDOR: 356847 ONE CIVIC SQUARE JASON WENDZEL CHECK AMOUNT: S 710.01 CARMEL, INDIANA 46032 8898 TORRANCE PLACE CHECK NUMBER: 307437 FISHERS IN 46038 CHECK DATE: 01/20/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4128000 710.01 TUITION REIMBURSEMENT -n @ C- < « . o m 0 2 $ Cl) q O k § 2 2 I 7 0 0 C o _ D q w } n q * ^ m \ 0 / k k k z CL < k 2 n N , O % o R ® k q r { 4t U k q k 0 ) _ m o o m - 30 O D / G m Cl. n ƒ T. % # m k z z z ƒ iuq -n 0 . O | % § z ® & _ J a i 3 « 2 r- z k g § . U k k % k & ƒ , 0 2 ; k § o ; 2 m ;L _ E f CD ; # f E 3 J 3 ± w ID C $ - CL E . E I / ! E § ƒ k & f 2 P. O % R , o o E R ° g ® C - � k § i { g / / , S [ a y CL § f c o cr %« , a m § i e /� § 2 m i ` cr - « � E 3 \ D \ 0 \ 0 ( 0 / -n \ co \/ k ° m 2 \ / � \ / / © # D Z a o k CD \ a \ k/ \ E 2 0 D eo a }_n m \ ( 90 & Q @ E °E M § \ M ? $ 0 0 / / 0 - - \ \ r- 0 £ 3 i \ CD C _ m c % ( ƒ % m c k © - O 2. § \ BE M -n G / f \ ] k ® _& \ C e 2 CD 2 0 CD § k \ Wendzel Tuition Reimbursement Class Credit Hours Cost per Credit Hour Total Computer Application 3 $ 135.15 $ 405.45 Intro to Homeland Security 3 $ 135.15 $ 405.45 Books $ 76.61 TOTAL CLASS COST $ 887.51 Allowed Reimbursement 80% TOTAL TO BE REIMBURSED $ 710.01 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 Jason Wendzel Department Fire _ S5N Hire Date 04/2004 Educational Institution* Ivy Tech Community College Name of Course** Computer Application3 Credit Hours Starting Date of Course(month/day/year) .10/1_7/16 _ By signing below, I signify that 1 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, I will repay the City in full for its tuition and book reimbursements for this course. • The tax status of ' n ursement pa t c its is subject'to federal law,which may change from time to time. Employee Signature'_ —C_.,-� C _ .-ti- ._ , Date 's Part H (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(1) year prior to the commencement of the course,and has not been subject to a disciplinary probation, suspension or demotion within 90 days prior"to the beginning of the course. The final claim will be paid from my department's budget,subject to the iern%,of lectiolin 5, of C;t rel City Code. Department Head Signature I�G��+� �/ - Date /15 Part III (to be completed by Director of Human Resources) Final Approval / "^�— `L. ```4"�" Date � <7/ ! 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. City Of Carmel Tuition Reimbursement Application Form Fart I(to be completed by employee) (Pleaseprlrrt. Submit completed form to Department F-leadrip 'or to coin menccmentofcourse.) Employee Name Jason Wendzel Department Fire — SSN Hire Date 0412004 Educational Institution* Introduction to Homeland Security Name of Course** Computer Application credit Flours 3 Starting Date of Course(month/day/year) 08/22/2016 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, I will repay the City in full for its tuition and book reimbursements for this course. • The tax status ofd" ibursemen a. merits is subject to federal law,which may change from time to time. Employee Signature ,/ _ _- - _ Date Part II (to be completed by Department Head) (Submit to Human ReSQUPCeS) By signing below, 1 certify that the applicant will have been employed full-time by the City for at least one(1) year prior to the commencement of the course, and has not been subject to a disciplinary probation, suspension or demotion within 90 days prior to tl6)be4bining of the tours The flivi claim will be paid from my department's budget, subject to the term o S jhn 18- C'rnnr .City Depertment,HW,Signature 7 Date _ — - Part III(to be completed by Director of Human Resources) Final Approval _G *-' t «'R*- '— _ Date — S f If denied, reason for denial * The tuition reimbursement program covers only full-semester courses offered through a degree-granting institution accredited by rhe North Central Association of Colleges and Schools or an equivalent regional accreditor. *" An application will riot be considered complete unless a course description from the school's literature is attached. AcademDecic Transcript C011 ec 2i m s of 005 PM I"is not an Oficial .Crveee~are n proWex may aka be mduded m Mie t,-scipt Transfer Credit Institution Credit Transcript Totals Courses In Progress Tranecrfpl Dale STUDENT IaPONMATWX Birth Date: 27-JUN Csegndun relmmadon Current Progress ASSOOote of APPeed Science Program: Indawpols Public Safety AAS Qerpusn Indianapolis "&*I Public Safety —"Transcript type:Unoffictal is NOT Official DEGREE AWARDED SougMf Assorlah of APpled Science Degree Date: CeeakWm TWormMroo Primary Degree Programs Indianapolis Public Safety AAS Compose: rndlanepulk Na)erf Pubk Safety -%r "led Corrrao laud Talo Grade t7adk Noun Qrralky Pahrt 1 HSPS 104 UG Intro.to EnWonmental 7ed1. A 3.000 12.DO Term Totals(UndmyrodMINIM) Attempt Noon Pawed Nsmn Eare ad Noon SPA liesm Qua ft Pohda GPA Curromt Term: 3 000 3.000 3.000 3.000 12.00 4.000 cumullwe: 39.000 39.000 39.000 39.000 156.00 4.000 Gubjed Course Iwai TM Grade CreM Noun Qsuwy Poleb a HSPS 101 UG Intro.to Homeland Seanq A 3.000 12,00 HSPS 110 UG Computer Applcawns-HSPS A 3A00 12.00 Atdempt HMM Passed NOen Earned Noun GPA Neuse Qwty Po-- GPA CDRent Terms 6.000 6.000 6.000 6.000 24.00 4.000 cumuladves 45.000 45.000 45.000 45.000 180.00 4.000 Unufloal9a ulpt CHASE O �'*MNMR 559620000250000007661000000006 SLATE P.O.BOX 15123 WILMINGTON,DE Get updates on the goPaymW ent DDate: 0911418 19850.5123 Log on to chase.comfalerts Now Blillanw: =78.81 Mlnlrrium Payment W.00! Account numberil 6982 $ Amount Enclosed 24182 BDC Z 73016 D Make your check payable 10:Chase Card Services JASON D WENDZEL CARDMEMBER SERVICE PO BOX 94014 PALATINE IL 60094-4014 S 0 0 016 0 2 8 219 CHASE O Manage your account online: Customer Service: ® Mable:Visa chase.com SLATE '-0° ° 2000 on your while braner ACCOUNT SUMMARY PAYMENT INFORMATION Account Number: 41100 awl OIe6 6982 New Balance $7661 Previous Balance SD OD Payment Due Data 09/14/16 Payment,Credits $Qoo Mi irrnurn Paymertl Due $2500 Purchases +$76.61 Late Payment Warning: If we do not receive yaw-minimum payment Cash Advances SO00 by the dabs listed above,you may have to pay a late fee of up 10$37.00. Balance Transfers so.00 Minimum Payment Warning:If you make only the minimum payment each period,you will pay more In interest and It Will take you kxlger in Fees Charged $ 0.00 pay off your balance. For example: Interest Charged $D.00 New Balance $76.61 If you make no You will pay off ttte And you will end up OpeninglClosing Date 07/18/16-08/17/16 additional charges using balance shown on paying an estimated Credit Limit $7,250 this card and each this statement in bow of... month you pay... about... Avalable Credit $7,173 Cash Acows Lite $1,450 Ontv the minimum 4 months S78 Available for Cash $1,450 payment Past Due Amount If you would Ike Information about credit counseling services,call 1-36&797-2885. Balance over the Credit Lima $D.00 1 ACCOUNT ACTIVITY Date of Tr 08!12 EBAY3 HALF.COM 80454b9657 CA 76.61 2016 Totals Year4o0ate Total fees charged in 2016 $0.00 Total Interest charged In 2016 $0.00 Year-to-date totals do not reflect arty fee or interest refunds you may have received. INTEREST CHARGES Your Annual Percentage Rate(APR)is the annual interest rate on your account. Annual Balance Balance Type Percentage Subject To Interest Rate(APR) Interest Rate Charges PURCHASES Purchases 12.24%(v) -4 -0- CASH ADVANCES Cash Advances 19.47%(v) -0- -0- BALANCE BALANCE TRANSFERS Balance Transfer 12.249/6(v) -04 -0- (v)=Variable Rate 31 Days in Billing Period Please see Information About Your Account section for One Calculation of Balance Subject to interest Rete,Annual Renewal Notice,How to Avoid Intend an Purchases,and other Irnpotant information,as applicable. This Statement is a Facsimile-Not an original 0000001 FK933339 D 13 030 N Z 17 16.0617 Patel 012 08849 LAMA 24182 2301000D130002418201 hVfcom My Acmrnt ' wah List SON MySturt ketp Renals 0 eBay Nome Sqn in (A Home Gaols Teztboois Norsk Moves Games 1WSno; oCart V Cat*W.es Go V Your order h25 tY^Pr.c4aoe 4 Thank.�Ou Order aum rttary Seller 1 9010aitlaot 00321 It; W% M imosot Orbe 2013:Irtroduct my(Shelly $14,10 Cashum)(Can Be Used bf Hy Tech Cins 101) (Hardooeer) 33.99 +►R09 Rein :XW*TOZ Of Au923 00.141tpt Ao=tW* S9Ixfmm itMw*.k A4 $ellecael CID01A9*}97% Irtroducim to HtmtdmW Security:Principin of $54.97 A-Haard<Ibsk Mutap~by Gaorpe 13.49 teas Mini Haddow,Jane B~and Darton P.CoppoV (2015 Paperback) -nMereaeyAug23 Qpn>iGo? 5nm%aw S9pe'W, ??ft MAffrpctWnutpe MMtbie Tort: s7e.et What woWd you lice to do necP Canume enoopho SON poursLtllofq:mn local �I tri 5tbpping.com Stiwkt eBay Ciessifiet7rs '1 Ass mote t;x yat-. •• Campfft pmd eL pr<es S:y"sall ail kdr js t" Frcr are'Hardty fxe3 an0 stares evert ti�eQ xisss:'+exs Home Bods TextbookN Music Mm�ies Games 'rintable Bill https://secure.touchnet.netIC20006 tsa/tapp?tapp-stoken=amkBeOvb.. Statement Tam Due Date Amount Due Data j08/16/2016 201 Fall16208I79JZ018 $99090 0 - 50 Met Fall Creek Pkwy N.Dr Indlarapolis,IN 48209 917.821.4800 Jason D.Wendzel http:1hvwvAtvytech.adu 8098 Torrance PI Flehers,IN 480383014 Student to:C0412M Fall 2016(201620)Schedule CRN SUBJ CRSE SEC I COURSE TITLE CREDS I DAYS STARTISTOP I BUILD ROOM 35268 HSPS 101 OOA I Intro.to Homel 3.00 TBA TBA INTA1 i INTA1 , 31037 j HSPS 110 1 OOH j ConV"Applic 3.00 TBA TBA WW V ! TBA J Total Credit Hours:8.001 Account Summary Charges [ Credits/Antlelpsted credits j Al-In State Tuition 4M.45! A1-Wernat Fee 80.00 j H1-In State Tuition 405.4511 H74ntemet Fee e0.00 I I H1 Technology Fee 60.00 Total Charges: S!ili0.90 Total CrediWAnticipsted Credits: $0.00 Pmvbus Balance Current Term Balaeee Mount Due Future Balance $0.00 $990.90 $990.90 $0.00 i nw '1n/n1/AA1L A.l�l�Tl I CHASE O I 59620000250000104164000000000 SLATE P.O.BOX 15123 Payment Due Dote: 10114116WILMIN3TON,DE Get updates on the go 1985D.6123 Log on to chase.com/alerts New 81hnOB: $1.041.64 Minimum Payment: $25.00 Account numbanylijaMWi4p 5962 Amount Enclosed 57592 9EX Z2511a D Make your check payatla to:Chase Cad Services JASON D WBJDZEL 8696 TORRANCE PL FISHERS IN 4MM-M14 CARDMBuBER SERVICE PO BOX 94014 PALATINE IL 60094.4014 5000160 2859628 CHASE O ■ Manage your account online: Customer Bios: , Mobile:Vel dlase.com SLATE t ron your moble browser ACCOUNT SUMMARY PAYMENT INFORMATION Account Number:416N 6662 New Balance $1,041.64 Previous Balance $76.61 Payment Due Date 10/14/16 Payment Credits 576.61 Minn n Payment Due $2600 Purchases +$1,041.64 Late Payment Warning:If we kb not receive your minimum payment Cash Advances $0.00 W the date feted above,you may have to pay a Isle fee of up to$57.00. Balance Transfers $0.O Minimum Payment Warning:If you make only the minimum payment each pew,You will pay more h Interest and it will take you Io ger to Foes Charged $13.00 pay off your balance. For example: Interest Charged $D.00 New Balance $1,041.64 If you make no You will pay off the And you w1 end up OpeningrCIcang Date Ofir16r16-09!17!16 additional charges ung balance shown on paying an estimated CntrR Limit $7,250 this card and each this statement in total of... month you pay... about... Available Credit 96 206 Cash Access Line $1,450 D 5 years 91,366 Available for Cash $1,450 payment Past Due Amount $O.00 $96 3 years $1251 Balance over the Credit Limit $0.00 (Savings=$114) It you would Ike Information about credit eoureelling services,cal 1.8W797-2866. ACCOUNT ACTIVITY Date of Transaction Merchant Name or Transaction Description $Amount PAYMENTS AND OTHER CREDITS 09109 Payment Thank You-Web -76.61 PURCHASES 06/19 PAYPATH 9 FEE IVY TECH 913-599-BM KS J2�5; 08119 IVY TECH CC INDIANA 317-92148M IN 09112 APL'ITUNES.COANBILL 868.712-7753 CA 10.69 2016 Touts Yew-ft Date Total fees charged in 2016 90.0 Total interest charged in 2016 $0.00 Year-todats totals do not reflect any tee or Merest rehnds you may halve received. INTEREST CHARGES Your Annual Percentage Rate(APR)is the annual interest rate an your account Annual Balance Balance Type Percentage Subject To Interest Rate(APR) Interest Rate Charges PURCHASES Purchases 12.24%(v) -0- ¢ CASH ADVANCES Cash Advances 19.49%(v) -0- -0- This Statement is a Facsimile-Not an original 0000001 FIS33M D a 000 N Z 17 15 0917 Page 1 0l 2 08M AW AIA 575M 25110000080OD5768-901 M ISM � H o o CD D _• O O S N i r r r+ O `G a Q Q O O O� rD rD CD -I H 3Ort rpt � j cu -z S n N rD rfDD (l �_�-* o y - n cr O O {�4 j eD 0 Q �3 N0- � don(D rD O W OM NLn W -1 o L-1 fD r Ln qq j 0 CCD o (D rD T r* rD .r�D 0 —� a o ... -,1 O_ C n N `G p Ln rD hV' D L ,D Q + --x O O O N O rt C rT '�h c rD Zr N V 3 :9T ZW3 � e. Ln � z T --1 V0 OJ fD QJ O 1 1 Ln d'QI N � NrD i N T rD ` H m 3 c CL � Ni L � IN CL o m ° ' c - 0 N � 00 (l4 N CD O_ `- Printable Bill Page 1 of 2 Statement Term Due Date Amount Due Date 08/02/2016 Fall 2016(201620) 08/19/2016 $1,533.35 50 West Fall Creek Pkwy N. Dr Indianapolis, IN 46208 317.921.4800 Michael DeLong http://www.ivytech.edu 12153 Belfry Dr Noblesville, IN 46060-6079 Student ID: C05192874 Fall 2016(201620) Schedule CRN SUBJ CRSE SEC COURSE TITLE CREDS DAYS START/STOP BUILD ROOM 24328 NRSG 200 C1H Complex Med-Sur 3.00 T 1200-0250pm LAWFB F214 24418 NRSG 208 A3H Practice Issues 2.00 TR 0300-0450pm LAWFB F211 38209 NRSG 201 C1H Complex Med-Sur 4.00 MWF 0630-0630pm LAWFB NOROOM Total Credit Hours:9.00 Account Summary Charges Credits/Anticipated Credits 1-11-In State Tuition 1000.35 H1-NCLEX Review 325.00 H1-Nurse Program Fee 125.00 H1-Technology Fee 60.00 N1-Capstone Fee 23.00 Total Charges: $1,533.35 Total Credits/Anticipated Credits: $0.00 Previous Balance Current Term Balance Amount Due Future Balance $0.00 $ 1,533.35 $ 1,533.35 $0.00 https:Hsecure.touchnet.net/C20006 tsa/tapp?tapp-stoken=ogzttdWbV5n&Navigate=print... 12/27/2016