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HomeMy WebLinkAbout181768 02/02/2010 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE s o CARMEL, INDIANA 46032 DEVELOPMENT ATTN: ACCT RECV CHECK AMOUNT: $9,431.46 io 101 N SENATE AVE CHECK NUMBER: 181768 INDIANAPOLIS IN 46206 -0847 CHECK DATE: 2/2/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4110000 1,560.00 FULL TIME REGULAR 1125 4110000 3,205.41 FULL TIME REGULAR 1201 4110000 1,560.00 FULL TIME REGULAR 1207 4110000 2,411.05 FULL TIME REGULAR 651 5023990 695.00 OTHER EXPENSES 133438 -1 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT BENEFIT ADMINISTRATION, 10 NORTH SENATE AVENUE, INDIANAPOLIS, IN 46204 -2277 Toll free 1 -800- 891 -6499 Marion County 232-7436 STATEMENT OF BENEFIT CHARGES (FORM 535) CONFIDENTIAL RECORD PURSUANT TO IC 22.4 -19 -6, IC 4 -1 -66 Page 1 CITY OF •CARMEL ACCOUNT/ ATTN CLERK TREASURER LOCATION NUMBER 133438 000 ONE' C I U I C S Q REPORTING MONTH DEC 2009 CARMEL IN W6032 -2584 NET CHARGES $9,428.46 POSTING DATE JAN-08, 2010 The receipt of this statement (Form 535) does not reopen the question of the claimant's eligibility for unemployment insurance since, before any payments were made the employer had the opportunity and the responsibility to report any inforrnation which could disqualify the claimant. SOCIAL BENEFIT PAID FOR SECURITY YEAREND CLAIM TRANSACTION WEEK AMOUNT NUMBER EMPLOYEES'NAME DATE LEVEL DATE ENDING ACP CHARGED THIS IS NOT A BILL OR A REQUEST FOR MONEY DUE TO THIS DEPARTMENT. It is a statement of benefit charges made to your account during the "reporting" month. At the end of the "posting" month, you will receive a Reimbursable Bill (Form 1067) for these charges and any previous liability still outstanding. NEW CHARGES FOR THE REPORTING MONTH 12/09 A MORELLI 09/0.4/10 REG 12/03/09 00 /00 /00 26.54joq 1 1 A MOSIER 11/06/10 REG 12/13/09 12/12/09 89.62 A MOSIER 11/06/10 REG 12/20/09 12/19/09 218.DOr, A MOSIER 11/06/10 REG 12/27/09 12/26/09 218.00 S M CARY 07/03/10 REG 12/21/09 12/19/09 47.06 S M_ CARY 07/03/10 REG 12/27/09 12/26/09 160.00 c J N SPENCE 10/23/10 REG 12/07/09 12/05/09 120.78 J N SPENCE 10/23/10 REG 12/14/09 12/12/09 168.00 J N SPENCE 10/23/10 REG 12/20/09 12/19/09 168.00 J N SPENCE 10/23/10 REG 12/27/09 12/26/09 168.00 M A KLAPPER 10/23/10 REG 12 /06/09 12/05/09 81.00 M A KLAPPER 10/23/10 REG 12/13/09 12/12/09 146.00 2 M A KLAPPER 10/23/10 REG 12/20/09 12/19/09 143..00 M A KLAPPER 10/23/10 REG .12/27/09 12/26/09 34.00 C C SECHREST 12/04/10 REG 12/21/09 12/19/09 900.00 C C SECHREST 12/04/10 REG 12/29/09 12/26/09 213.08 M A MONTGOMERY 08714710 REG 12/01/09 11728709 357.00 M A MONTGOMERY 08/14/10 REG 12/09/09 12/05/09 357.00 M A MONTGOMERY 08/14/10 REG 12/14/09 12/12/09 357.00 -1 M A MONTGOMERY 08/14/10 REG 12/21/09 12/19/09 357.00 2 M A MONTGOMERY 08/14/10 REG 12/28/09 12/26/09 12.05 2 J C MOREDOCK 05/29/10 REG 12/27/09 12/26/09 86.99 0 D M LINGELBAUGH 09/18/10 REG 12/06/09 12/05/09 390.00 D M LINGELBAUGH 09/18/10 REG 12/13/09 12/12/09 390.00 D M LINGELBAUGH 09/18/10 REG 12/20/09 12/19/09 390.0011 D M LINGELBAUGH 09/18/10 REG 12/2.7/09 12/26/09 390.00 D EFRIESEN 11/13/10 REG' 12/14/09 11/28/09 346.00 z J L HOPE 0e/f4710 REG 12/07/09 12/05/09 390.00 I J L HOPE 08/14/10 REG 12/15/09 12/12/09 390.00 l(") CONTINUE ON NEXT PAGE An in the ACQ column denotes a charge resulting from an acquisition of another business. Account/Location Number: 133438 —000 Reporting Month: DECEMBER, 2009 Page 2 Employer Name: CITY OF CARMEL SOCIAL BENEFIT PAID FOR SECURITY YEAREND CLAIM TRANSACTION WEEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING ACO CHARGED NEW ('L RGES FOR THE REPORTING MONTH 12/09 J L HOPE 08/14/10 REG 12/23/09 12/19/09 390.00 J L HOPE 08/14/10 REG 12/29/09 12/26/09 390.00 E, E SWIRSKY _W._.----- 07 24 10 REG 12/ 12/05709 24.68 H E E SWIRSKY 07/24/10 REG 12/29/09 12/26/09 105.26‘“ L D E TABELING 11/13/10 REG 12/02709 11/28/09 125.00 D E TABELING 11/13/10 REG 12/07/09 12/05/09 125.00 D E TABELING 11/13/10 REG 12/14/09 12/12/09 125.00 �I� D E TABELING 11/13/10 REG 12/21/09 12/19/09 125.00 D E TABELING 11/13/10 REG 12/28/09 12/26/09 125.00 J M PENIT 10/16/10 REG 12/07/09 12/05/09 172.00 3 M PENN 10/16/10 REG 12/14/09 12/12/09 172.00 Cl J M PENN 10/16/10 REG 12/21/09 12/19/09 172.00\ 1 3 M PENN 10/16/10 REG 12/28/09 12/26/09 172.00 J G KOZLOVICH JR 06/05/10 REG 12/18/09 12 12 09 378.00 J G KOZLOVICH JR 06/05/10 REG 12/28/09 12/26/09 314.00\.Q TOTAL NEW CHARGES FOR THE REPORTING MONTH 12/09 9,428.46 TOTAL AMOUNT OF NET CHARGES 9,428.46 END OF BENEFIT CHARGE STATEMENT I C IL 1 C Or i i7c 7 1 10 1 -4, k 6L ,s 4 0,3 7) or t 0,,r7 12-o vs (Q- oo 44 Y,0 L\' 1 a Z0 1:5�0.Uv 4 0 '404 v 0 )2-0 1 1 0 0 0 An in the ACQ column denotes a charge resulting from an acquisition of another business. ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. 146500 Indiana Dept. of Workforce Development Terms 10 North Senate Ave., SE106 Date Due Indianapolis, IN 46204 -2277 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 1/8/10 133438 Benefit charge Dec'09 23052 2,801.41 PQY*ALL 101;per Michael 11/20/08.M! Total 2,801.41 1 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 Clerk- Treasurer Ii Voucher No. Warrant No. 146500 Indiana Dept, of Workforce Development Allowed 20 10 North Senate Ave., SE106 Indianapolis, IN 46204=2277 In Sum of 2,801.41 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or Board Members INVOICE NO. ACCT AMOUNT Dept TITLE 23052 133438 4110000 1 I hereby certify that the attached invoice(s), or 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 28 -Jan 2010 /2/fr/h1,0 Signature 2,801.41 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund VOUCHER 097212 „WARRANT ALLOWED '146500 IN SUM OF IN DEPT OF WORKFORCE DEVEL. Benefit Administration 10 N. Senate Avenue Indianapolis, IN 46204 Carmel Wastewater Utility j ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 133438 01- 4080 -12 $692.00 Voucher Total $692.00 Cost distribution ledger classification if claim paid under vehicle highway fund c oot Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show, kind of service, where performed, dates of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 146500 IN DEPT OF WORKFORCE DEVEL. Purchase Order No. Benefit Administration Terms 10 N. Senate Avenue Due Date 12/30/2009 Indianapolis, IN 46204 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 121301200! 133438 $692.00 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 Date Officer Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. k Payee Y 1'lJ�[i�;c��� "���tL CV' Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) v: Total 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 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 U rea IN SUM OF 1-- 551.06 ON ACCOUNT OF APPROPRIATION FOR Q3701::P Ly2ACAK) Board Members PO# INVOICE NO ACCT #/TITLE AMOUNT hereby certify DEPEP T. I hereb certif that the attached invoice(s), or I U b 1)( 15(X, 0 p bill(s) is (are) true and correct and that the ■2-01 h[) b b )41.0S materials or services itemized thereon for f')(-)(2)b i6(00 i) U which charge is made were ordered and received except Y f_, 20 p' 1 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ,ALLOWED 20 likliana Department of Workforce Development Benefit Administration IN SUM OF 10 North Senate Avenue Indianapolis, IN 46204 -2277 $1,560.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# Dept. INVOICE NO ACCT /TITLE AMOUNT Board Members 1201 j 133438 -000 41 100.00 $1,560.00 I hereby certify that the attached invoice(s), or I f 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 Thursday, January 28, 2010 Director, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 01/08/10 133438 -000 Lingelbaugh Unemployment $1,560.00 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accordance with IC 5- 11- 10 -1.6 ,20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN Department of Workforce Development Benefit Administration IN SUM OF 10 North Senate Avenue Indianapolis, IN 46204 -2277 $2,411.05 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1207 133438-000 43-470.00 $2,411.05 I hereby certify that the attached invoice(s), or 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 Wednesday, January 20, 2010 Director, Brook YSlre Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 199; ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 01/08/10 133438 -000 Unemployment $2,411.0 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 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Indiana_ Department of Workforce Development IN SUM OF 10 North Senate Avenue Indianapolis, IN 46204 $1,560.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 41- 100.00 $1,560.00 1 hereby certify that the attached invoice(s), or 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 FEB-! 2010 1` Ix) Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) $1,560.00 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 Clerk- Treasurer