HomeMy WebLinkAbout185606 05/25/2010 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE
11 1 1 CHECK AMOUNT: $6,898.81
CARMEL, INDIANA 46032 DEVELOPMENT ATTN: ACCT RECV
101 N SENATE AVE CHECK NUMBER: 185606
INDIANAPOLIS IN 46206 -0847
CHECK DATE: 5/25/2010
DEPARTMENT ACCOUNT PO NUMB INVOIC NUMBER AMOUNT DESCRIPTION
1125 4110000 366.31 FULL TIME REGULAR
1160 4110000 1,560.00 FULL TIME REGULAR
1192 4110000 3,510.00 FULL TIME REGULAR
1207 4111000 292.50 PART -TIME
601 5023990 1,170.00 OTHER EXPENSES
133438 -1
INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT
BENEFIT ADMINISTRATION, 10 NORTH SENATE AVENUE, INDIANAPOLIS, IN 46204 -2277
Toll tree 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 CIVIC SQ REPORTING MONTH APR, 2010
CARMEL IN 46032-2584
NET CHARGES $6 ,898.81
POSTING DATE MAY-09, 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 information which could disqualify the claimant.
SOCIAL BENEFIT AID FOR
SECURITY YEAR END CLAIM TRANSACTION WEEK AMOUNT
NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING ACO 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 (NARGES FOR THE REPORTING MONTH 04/10
E 0 EDEDUWA 07/25/09 EB 04/11/10 04/10/10 i�l 97.50
E 0 EDEDUWA 07/25/09 EB 04/19/10 04/17/10';1� 97.50 f
E 0 E DEDUWA 07/25/09 EB 04/26/10 04/24/10 97.50 1
D D NORRIS 617158711 REG 04/06710 04703/10 390.00
D D NORRIS 01/08/11 REG 04/11/10 04/10/10 390.00
D D NORRIS 01/08/11 REG 04/19/10 04/17/10 390.00
D D N ORRIS 0 1/08/11 REG 04/25/10 04/24/10 3 90.00
072E 11 REG 04 20110 04/10 10 390.00 ..._.i
R 0 LOVELL 03/26/11 REG 04/20/10 04/17/10 390.00 '110
R 0 LOVELL 03/26/11 REG 04/26/10 04/24/10 390 .00 l
K NE 0210 RE G 0 4/26/10 0 4/24 /1 0 8_2.31
B ROUSE— DEVORE 12 /25/10 REG 04 /04/10 03/27/10 39C.00
L B ROUSE— DEVORE 12/25/10 REG 04/09110 04/03/10 390.00
L B ROUSE DEVORE 12/25/10 REG 04/16/10 04/10/10 1 SL' 390.00
L B ROUSE DEVORE 12/25/10 REG 04/23/10 04/17/10 1� 390.00 C
L B RO_US_ _E— DEVORE 12/ 25/10 _RE 04/27/10 04/24/1 390.0
J M PENN 10/16/10 REG 04/06/10 04/03/10 t� 172.00
J M PENH 10/16/10 REG 0 04/1 �r 1 112.00
a
W POH.G._ 12 /ZSTO REG D4�5/10 04/03/10 390.00
B W POHL 12/18/10 REG 04/11/10 04/10/10 1 390.00
B W POHL 12/18/10 REG 04/18/10 04/17/10 390.00
I i B W POHL 12/18/10 REG 04/25/10 04/24/10 390.00
TOTAL NEW CHARGES FOR THE REPORTING MONTH 04/10 6,898.81
TOTAL AMOUNT OF NET CHARGES 6,898.81
a
An in the ACO column denfit6sF-y8h AA.RWUti6V6f another business.
,,VOUCHER 101705 WARRANT ALLOWED
t
`146500 IN SUM OF
IN DEPT OF WORKFORCE DEVEL.
10 N. Senate Avenue, Ste 106
Indianapolis, IN 46204
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
0410 01- 4080 -12 $1,170.00
Voucher Total $1,170.00
Cost distribution ledger classification if
claim paid under 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 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.
10 N. Senate Avenue, Ste 106 Terms
Indianapolis, IN 46204 Due Date 5/20/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/20/2010 0410 $1,170.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Department of Workforce Development
IN SUM OF
Benefit Administration, 10 N. Senate Ave
Indianapolis, IN 462042277
$1,560.00
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1160 133438 -000 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
Thursday, May 20, 2010
Mayor
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 N umber (or note attached invoice(s) or bill(s))
05/09/10 133438 -000 $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
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
5/9/10 133438 Benefit charge A r'10 366.31
.PAY ALL OUT OF 10,1;' ,er 11!20/08
Total 366.31
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
Voucher No. Warrant No.
146500 Indiana Dept. of Workforce Development Allowed 20
10 North Senate Ave., SE106
Indianapolis, IN 46204 -2277
In Sum of
366.31
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT AMOUNT Board Members
Dept TITLE
1125 133438 4110000 366.31 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
20 -May 2010
Signature
366.31 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN Department of Workforce Development
Benefit Administration IN SUM OF
10 North Senate Avenue
Indianapolis, IN 46204 -2277
$292.50
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
1207 133438- 41- 110.00 $292.50 1 hereby certify that the attached invoice(s), or
anAppin
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, May 19, 2010
D 441
Director, Brockthire 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))
05/19/10 133438- OOAPR10 Unemployment $292.4
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
Benefit Administration
10 North Senate Avenue
Indianapolis, IN 46204 -2277
$3,510.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# l Dept. INVOICE NO. ACCT #ITITLE AMOUNT Board Members
1192 41- 100.00 $3,510.00 1 hereby certify that the attached invoice(s), or T
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, May 24, 2010
a
i D S
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 k.
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))
04/30/10 Unemployment Bryan pohl and Laura Rouse Devore $3,510.00
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