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Home My WebLink About183821 03/29/2010 °u CITY OF CARMEL, INDIANA VENDOR: 120950 Page 1 of 1 ONE CIVEC SQUARE DOUGLAS HANEY CARMEL, INDIANA 46032 CIO DEPT OF LAW CHECK AMOUNT: $4,305.84 C/O DEPT OF LAW CHECK NUMBER: 183821 CHECK DATE: 312912010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4128000 4,305.84 TUITION REIMBURSEMENT City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head rp or to commencement of course.) Employee Name poz, Department lit m) SSN Hire Date eP a-o 7 Educational Institution* 4all &ij F17 a W-e- 4 d 160,, dec Name ofCourse E'v_ c.0 Cad M CS___� 1 Starting Date of Course (month/day /year) o� �G// y i&J 0 3/ 90 5.6, O hook -s r/oo $y By signing below, I signify that I understand the following. _r�% 3f>S• S to i,-L_ The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -59. 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 the book list for the course and an original itemized receipt for all books purchased. 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 reimbursement payments is subject to federal law, which may change from time to time. r� Employee Signat Date 0 7— q Part II (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 terms of Section 2 -59 of Carmel City Code. Department Head Signature Date l Z Part III (to be completed by Director of Human Resources) A Final Approval r u Date 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 accrediter. An application will not be considered complete unless a course description from the school's literature is attached. Rev June 07 Account Summary by Term Page 1 of 1 Anticipated third party contract payments, financial aid, and memos are NOT included in this summary. Please Allow 24 Hours for payments to be posted to your account. Summary Account Balance: $3,905.00 2010 Spring Qtr 03/08 -05/30 Detail Code Description Charge Payment Balance 5CPO PhD in Public Policy Admin $4,300.00 $3,905.00 TFEE Walden Technology Fee $35.00 $0.00 DP01 PhD PPA Reduction $430.00 $0.00 Term Charges: $4,335.00 Term Credits and Payments: $430.00 Term Balance: $3,905.00 2009 Winter Qtr 12/07 -02/28 Detail Code Description Charge Payment Balance 3CPO PhD in Public Policy Admin $4,300.00 $0.00 TFEE Walden Technology Fee $35.00 $0.00 DP01 PhD PPA Reduction $430.00 $0.00 DPP1 PhD Pub Policy Admin Reduction $0.00 $0.00 PLCK Cash Receipt $3,905.00 $0.00 Term Charges: $4,335.00 Term Credits and Payments: $4,335.00 Term Balance: $0.00 2009 Fall Qtr 09/08 -11/30 Detail Code Description Charge Payment Balance 1CP0 PhD in Public Policy Admin $2,580.00 $0.00 1CPP PhD Public Policy Admin $0.00 $0.00 TFEE Walden Technology Fee $35.00 $0.00 DP01 PhD PPA Reduction $258.00 $0.00 DPP1 PhD Pub Policy Admin Reduction $0.00 $0.00 PLCK Cash Receipt $2,357.00 $0.00 Term Charges: $2,615.00 Term Credits and Payments: $2,615.00 Term Balance: $0.00 Account Balance: $3,905.00 https:// ssb. watdenu. edu /pls /PROD/bwskoacc.P_VlcwAcct 31512010 Final Grades Page 1 of 1 Student Information Current Program Doctor of Philosophy Level: Doctorate Quarter Program: Doctor of Philosophy PPA Admit Term: 2009 Fall Qtr 09/08 -11130 Admit Type: Deferred to a New Term Catalog Term: 2009 Fall Qtr 09/08-11130 College: College of Social and Behv Sci Campus: Walden Major and Department: Public Policy and Administrat, Pub Policy and Administration Major Concentration: Law and Public Policy Academic Standing: Doctorate Quarter Course work CRN Subject Course Section Course Title Campus Final Attempted Earned GPA Quality Grade Hours Points 13244 PPPA 8431 1 Finance Budgt for Pub Walden A 5.000 5.000 5.000 20.00 Sec 13448 PPPA 8810 1 Fund of Law Pub Pol Walden A 5.000 5-000 5.000' 20.00 Doctorate Quarter Summary Attempted Earned GPA Hours Quality Points GPA Current Term: 10.000 10.000 10.000 40.00 4.00 Cumulative: 16.000 16.000 16.000 64.00 4.00 Transfer: 0.000 0.000 0.000 0.00 0.00 Overall: 16.000 16.000 16.000 64.00 4.00 Select another Term https: /ssb.waldenu.edu /pls /PROD /bwskogrd. P_V lewGrde 3/5/2010 Walden University Online Online Bookstore: May Account My Order History Page 1 of 1 1 WALDEN UNIVERSITY A. hr' her degree. A higherpurpose. Home My Account Help Contact Us Log Out CHATLIVENOW My Account: My Order History and Status Order Number: 10712584 Tracking Number: IZSX097XO334699117 Shipment Type: UPS Ground Subtotal: 379.70 Shipping: 11.14 Grand Total: 390.84 Order Date: 11/10/2009 Order Status: Complete, On Backorder 1 i r Author Title Type Qty Price Carter, Christine B. Administrative Law and Politics: Cases and Comments Paperback 1 $96.00 American Psychological Concise Rules of APA Style -2009 Edition Spiral 1 $28.95 Association Mikesell, John Fiscal Administration Hardback 1 $199.50 Walden University Mmpa 6431: Finance and Budgeting.. Public -DVD DVD 1 $10.00 Walden University Mmpa 6810: Fund. of Law and Public Policy -DVD DVD 1 $10.00 Kerwin, Cornelius Rulemaking How Government Agencies Write Law and Make Policy Paperback 1 $35.25 M. Copyright 2010 MBS Direct 2711 West Asti St Columbia, Mp 65203 Privacy Policy Disclaimer Your Textbooks Partner https: //bookstore.mbsdirect. net /vb_account.php? ACTION= orderdetal l &ord= RemUsDnB %2... 3/5/2010 Walden University Online Online Bookstore: My Account My Order History Page 1 of I ALLEN UNIVERSIT I A higher degree. A higher purpose. Home My Account Heip Contact Us Log Out My Account My Order History and Status Order Number: 10712584 Tracking Number: 1ZSX097XO3347 83472 Shipment Type: UPS Ground Subtotal: 10.00 Shipping: 0.00 Grand Total: 10.00 Order Date: 11/12/2009 Order Status: Backorder Complete M I Author Title Type Qty Price Walden University Mmpa 6810: Fund. of Law and Public Policy -DVD DVD 1 $10.00 Copyright 2010 MBS Direct 2711 West Ash St Columbia, MO 55203 1 Privacy Policy Disclaimer Your Textbooks Partner https: bookstore .mbsdirect.net /vb_account.php ?ACTION= orderdetalI &ord= NJwN51 VnXE... 31512010 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 Douglas C. Haney Purchase Order No. Terms Carmel, Indiana 46033 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3 15 10 Reimburse Douglas C. Haney for monies he personally expended to attend Walden University's on -line courses, "Finance and Budgeting for the Public Sector" an Fundamentals of aw and Public Police' per the attached receipts and forms Total Q I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited sam��I�C' c &Unce with IC 5- 11- 10 -1.6. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Douglas C. Haney IN SUM OF Carmel, Indiana 46033 t $4,305.84 e ON ACCOUNT OF APPROPRIATION FOR DEPARTMENT OF LAW 1180 410 -28000 Tuition Reimbursement Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1180 14,305.84 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 t� S 20 (7 nture Cost distribution ledger classification if Title claim paid motor vehicle highway fund