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Home My WebLink About325752 05/30/18 �nqR. CITY OF CARMEL, INDIANA VENDOR: 00351805 b ONE CIVIC SQUARE IN DEPT OF ENVIRONMENTAL MGMT CHECK AMOUNT: $'`""""30.00' s ,Q: CARMEL, INDIANA 46032 100 N SENATE AVENUE CHECK NUMBER: 325752 MAIL CODE 66-34 CHECK DATE: 05/30/18 INDIANAPOLIS IN 46204-2251 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 288228 30.00 OTHER EXPENSES VOUCHER NO. 181648 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor# 00351805 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER IN DEPT ENVIRONMENTAL MGMT CITY OF CARMEL MAIL CODE 66-34 An invoice or bill to be properly itemized must show: kind of service,where performed, INDIANAPOLIS, IN 46204-2251 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit,etc. Payee 30.00 00351805 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR IN DEPT ENVIRONMENTAL MGMT Terms Carmel Water Utilitv MAIL CODE 66-34 Due Date BOARD MEMBERS I hereby certify that that attached invoice(s), INDIANAPOLIS, IN 46204-2251 or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT RAYLE 01-6040-03 $30.00 and received except 5/22/2018 RAYLE $30.00 C-�'••.'Y leu � " 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. , 20_ Clerk-Treasurer IDEM Indiana Department of Environmental Management N MO Code 66-34 N.Senate venue Invoice Number: 8796932 l Renewal Fee: 30.00 Indianapolis,IN 46204-2251 Money Receipt# (Office Only) Certificate Number: W17120205 May 10,2018 Expiration Date: 06/30/2018 Grade: WT3 Jacen H.Rayle 001171 Obtained By: Examination 23690 Dunbar Rd. Arcadia IN 46030 Login: Use the Register a Person option and enter your license(certification)number and registration code ONLY to create your login credentials. Registration Code:765246 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Water Works Operator Certification Renewal Fee Statement Our records indicate your Water Works Certificate No. WT120205, Grade WT3 for a class WT3 Water Treatment Plant expires on June 30, 2018. You are required to obtain 25.00 contact hours of continuing education for renewal; a minimum of 70% must be technical. Our records indicate that you currently have accumulated 31.50 contact hours towards renewal. (This may not reflect hours for courses recently attended.) If you need to verify the number of technical course hours obtained, you may login online using the instructions below. Note: If you have not recently attended an approved course, and you do not have the required number of hours, you need to attend courses prior to June 30, 2018. After this date you are on expired status and are not a valid certified operator, and you may not perform any duties as a certified operator. You do have until June 30, 2019 to get your continuing education hours and renew your certification without retesting. Failure to renew by June 30, 2019 will result in termination of your certification, and you will have to retest. Online Renewal—Online renewal is available 24 hours a day, 7 days a week at https://mvlicense.in.,gov. The cost for the online renewal is $30.00 plus an additional processing fee for each certification renewal. The forms of payment accepted online are Visa, Master Card, &Discover credit and debit cards. Use the Register a Person option to enter your license (certification) number and registration code (listed above) only to create your login credentials. 1 Mail Renewal—To renew through the mail, please fill out the section on the back of this page and return this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take longer than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x $30/per renewal) = $90 combined fee. Remit Payment to: Indiana Department of Environmental Management Drinking Water Branch, OWQ, Mail Code 66-34 j 100 N. Senate Avenue J, Indianapolis, IN 46204-2251 (1) Cancel Certification —If you do not want to renew this certification, please write "CANCEL" on this form, sign and date in spaces provided, and mail to the remittance address listed on page 1. FILL OUT & RETURN ENTIRE LETTER WHEN RENEWING BY MAIL OR CANCELLING If this certification was obtained by Examination and the facility you are employed at has changed, please add your new employer in the space provided. NOTE—If this certification is Grandfathered or Site Specific, it is valid only for the location below. Operator Number: WTI 20205 Invoice Number: 8796932 PWS Name PWS ID Carmel Water Department 15229004 Address Change: 23tociG 26. ARCAk. 1i!. Mimosa Home Phone'Number: � `� ) 1,01 •S10_70 Work Phone Number: Operator Signature: ,• Z 4 Date: 5 • 16 - !S (2)