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Home My WebLink About182982 03/03/2010 CITY OF CARMEL, INDIANA VENDOR: 353873 Page 1 of 1 n ~t ONE CIVIC SQUARE NORMAN RILEY •ii CHECK AMOUNT: $30.08 CARMEL, INDIANA 46032 CHECK NUMBER: 182982 CHECK DATE: 3/3/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 30.08 EMPLOYEE PENSIONS B Subm Email Pnnto m Prescribed by State Board of Accounts General Form No. 101 (1955) MILEAGE CLAIM UTILITIES TO DALE RILEY 6775 E. 241 ST. ST CICERO, IN HAMILTON COUNTY DR. (G overnmental Unit) SEWER WWTP On Account of Appropriation No. for (Offi Board. Department or Insti on DATE FROM TO ODOMETER READING' NATURE OF BUSINESS AUTO MILES MILEAGE 50 20 Point Point Start Finish TRAVELED PER MILE 2/2412010 WWTP BROWNSBURG,IN zn na RESIDUAL SEMINAR r zn np 1 15 04 2124/2010 BROWNSBURG,IN WWTP 30.08 60.16 30.08 15 04 Auto License No. TOTALS Oil 0.00 30.08 SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing all just credits, and that no part of the same has been paid. n Date Z'S t 1 D i�J rt-e� Page 1 of 1 X1 I x' [x X. xJ A ST Notes Trip to Brownsburg Town Administrative 61 N Green St, Brownsburg, IN 46112 (317) 852 -1120 30.08 miles about 38 minutes 9609 Hazel Dell Pkwy, Indianapolis, IN 46280 -2935 1. Start out going SOUTH on HAZEL DELL PKWY toward go OA mi E 96TH ST. 2. Turn LEFT onto E 96TH ST. go 0.7 mi 3. Turn RIGHT onto ALLISONVILLE RD. go 1.3 mi 4. Merge onto 1 -465 W US -52 W. go 10.0 mi 5. Merge onto 1-465 S toward 1 -65 S. go 9.2 mi Will F 6. Merge onto I -74 W via EXIT 166 toward PEORIA ILL.. go 7.5 mi 7. Take the IN -267 exit, EXIT 66, toward BROWNSBURG. go 0.2 mi 8. Turn RIGHT onto IN -2671 N GREEN ST. go 1.2 mi 9. 61 N GREEN ST is on the LEFT. go 0.0 mi G:. Brownsburg Town Administrative (317) 852 -1120 61 N Green St, Brownsburg, IN 46112 Total Travel Estimate 30.08 miles about 38 minutes All rights reserved. Use subject to License /Copyright I Map Legend Directions and maps are informational only. We make no warranties on the accuracy of their content, road conditions or route usability or expeditiousness. You assume all risk of use. MapQuest and its suppliers shall not be liable to you for any loss or delay resulting from your use of MapQuest. Your use of MapQuest means you agree to our Terms of Use 2/25/2010 R Form Residuals: Addressing Treatment Issues in the Plant INDIANAN** LIVE LOCA'T'ION Brownsburg, IN Town Hall 11 W a t er February 24, 2010 ..ri Ci Registration 7:30 8:30 a.m. E nvironment Presentations Lunch 8:30 a.m. 3:15 p.m Association s, 'WEBINAR LOCA'T'IONS This event has been approved by IDEM Elkhart Comf Suites for 5 technical contact hours at Jasper Hampton Inn. Brownsburg and 4 at the (Presentation date and times are the same) webinar locations Brownsburg Jasper Please choose your location: Elkhart JPayment eF�txant ormatton Member $50 Brownsbu $40 j asper or Elkhart J P Name Non Member— $80 Brownsburg $70 Jasper or Elkhart (Includes IWEA Membership) Non Member $135 Brownsburg $125 Jasper or Elkhart company l T 6 r CAP EL (Includes IWEA PVEF MembcrA iQ)" B' Address *The $70 -80 non member rate includes a one -year membership in the IWEA only_ city D P LS state A zip V **The $125 -135 non member rate includes, upon completion of a membership application, a one year operator class membership in –7 F the Water Environment Federation and IWEA, the Indiana Wa- Phone ter Enviro Association. Check enclosed (Made payable to IWEA) Ck FMail Purchase Order It S 1 1 q 5 LZSJ If Aunlicable Credit Card (For your security, please call the office with F] your credit card information) l Certification Number please mad check and completed foam IWEA Grade Class 200 South Meridian, Suite 410 Indianapolis, IN 46225 Expiration Date 3 a d 1 0 Telephone: 317 328 -2151 Fax: 317- 328 -2545 (Before January 28, 2010) Ow fax number and address will be ch2tiging after lanuary 28th. Please contact the office for this new information. WASTEWATER OPERATOR/APPRENTICE CONTINUING To ensure Proper credit, the wastewater approval number EDUCATION CREDIT REPORT MUST be provided. State Form 51139 (R3 4-08) Training Course Approval Number: d' INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT ®Operator ❑Apprentice Technical Contact Hours Earned: General Contact Hours Earned: In accordance with 327 IAC 5- 22- 17(c the training provider must submit this form within ninety (90) days of the conclusion of the wastewater treatment continuing education course. Mail the completed form to: Wastewater Continuing Education Coordinator Indiana Dept. of Environmental Management 100 N. Senate Ave Mail Code 65-42 Indianapolis, IN 46204 -2251 Incomplete forms will be returned to the training course provider for completion and resubmittal to IDEM. Partial course credit shall not be given to instructors, speakers, or students participating in less than a complete wastewater treatment continuing education course. The training provider must retain a copy of this form for their records for a three (3) year period following the presentation of each wastewater treatment continuing education course. Training providers are encouraged to provide a copy of the completed and signed credit reporting form to the certified operator /apprentice attending the entire wastewater operator continuing education course. 1. NAME: 2. ADDRESS (number and street): City: State: ZIP code: Telephone number: Work: Home /Cell: Q j Check here if this is an address change E mail Address: 3. NAME OF TRAINING COURSE: 4. NAME OF TRAINING COURSE PROVIDER: l 5. NAME OF ORGANIZATION SPONSORING COURSE: Indiana Water Environment Association 6. DATE(S) ATTENDED (month, day, year): 7. LOCATION ATTENDED: 8. TOTAL NUMBER OF CONTACT HOURS ATTENDED BY CERTIFIED OPERATOR/APPRENTICE AND VERIFIED BY INSTRUCTOR AND TRAINING COURSE PROVIDER: Technical Contact Hours: General Contact Hours: 9. CERTIFICATE OF COMPLETION IS REQUIRED FOR ALL ON-LINE COURSES. I, the undersigned, certify under penalty of law that this document (and any attachments) were prepared under my direction or supervision and that the information submitted is, to the best of my knowledge and belief, true, accurate, and correct. I also understand that any omissions or misrepresentation may result in the denial of continuing education credit for this course. 10. SIGNATURE OF'INSTWCTOR: 11. PRINTED NAME OF INSTRUCTOR: 12. SIGNATURE OF CERTIFIED OPERATORIAPPRENTICE: 13. PRINTED NAME OF CERTIFIED OPERATORIAPPRENTICE: t t.. 14. CONTINUING EDUCATION CREDIT HOURS ARE TO BE APPLIED TO: Operator certification/apprentice number. Class: Expiration date: C Operator certification /apprentice number: Class: Expiration date: i 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 T9959 RILEY, NORMAN Purchase Order No. WASTEWATER Terms Due Date 2/25/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/25/2010 022410 $30.08 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 fficer 1 VOUCHER 097409 WARRANT ALLOWED T9959 IN SUM OF RILEY, NORMAN WASTEWATER Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 022410 01- 7042 -06 $30.08 Voucher Total $30.08 Cost distribution ledger classification if claim paid under vehicle highway fund