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HomeMy WebLinkAbout183706 03/29/2010 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CHECK AMOUNT: $235.10 CARMEL, INDIANA 46032 DEVELOPMENTATTN: ACCT RECV 101 N SENATE AVE CHECK NUMBER: 183706 INDIANAPOLIS IN 46206 -0847 CHECK DATE: 3/29/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4110000 GOLF 235.10 FULL TIME REGULAR 567041 -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 BLOCKOMS GOLF MANAGEMENT COMPANY L L C ACCOUNT/ 12120 BROOKSHIRE PKWY LOCATION NUMBER 567041 000 CARMEL IN 46033 -3314 REPORTING MONTH FEB, 2010 NETCHARGES $235.10 POSTING DATE MAR 07, 2010 The receipt of this statement (Form 535) does not reopen the question of the claimant's eligibility for unemployment insurance since, before any pnyments .were madc- the employer had the opportunity and the responsibility to report any information which could disqualify the claimant, SOCIAL i BENEFIT PAID FOR SECURITY YEAR END I CLAIM W EEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING A CHARGED NEW CHARGES FOR THE REPORTING MONTH 02/10 M A MONTGOMERY 08/14/10 'REG 02/24/10 02/20/10 235.10 TOTAL NEW CHARGES FOR THE REPORTING MONTH 02/10 235.10 TOTAL AMOUNT OF NET CHARGES 235.10 END OF BENEFIT CHARGE STATEMENT An in the ACO column denotes a charge resulting from an acquisition of another business. VOUCHER NO. WARRANT NO. ALLOWED 20 IN Department of Workforce Development Benefit Administration IN SUM OF 10 North Senate Avenue Indianapolis, IN 46204 -2277 $235.10 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO, ACCT #ITITLE AMOUNT Board Members 1207 567041- 41- 100.00 $235.10 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 Monday, March 15, 2010 a�id A Director, Brook ire 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)) 02/28/10 567041- OOOFEBI Unemployment $235.1 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