The URL can be used to link to this page

Home My WebLink About190145 09/28/2010 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE O DEVELOPMENT ATTN: ACCT RECV CHECK AMOUNT: $1,997.47 CARMEL, INDIANA 46032 101 N SENATE AVE CHECK NUMBER: 190145 INDIANAPOLIS IN 46206 -0847 CHECK DATE: 9/28/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4110000 090310 1,315.00 FULL TIME REGULAR 1207 4111000 090310 292.47 PART -TIME 601 5023990 090310 390.00 TAXES- PAYROLL 133438 -1 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT BENEFIT ADMINISTRATION, 10 NORTH SENATE AVENUE, INDIANAPOLIS, IN 46204 -2277 Toll Iree 1 -800- 891 -6499 Marion County 232 -7436 STATEMENT OF BENEFIT CHARGES (FORD 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 AUG, 2010 CARMEL IN 46032 2584 NET CHARGES POSTING DATE SEP 03 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 PAID FOR SECURITY YEAR END GLAIM TRANSACTION WEEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING ACQ 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 08/10 C HURRAY 06/04/111 RE G 0 08 /14/10 132.00' TOTAL NEW CHARGES FOR THE REPORTING MONTH 08 /10 1,997.-,47 TOTAL AMOUNT OF NET CHARGES 1,997.47 TAL END OF BENEFIT CHARGE STATEMENT VIED 5tr 16 2 1O BY. An in the ACID 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 146500 Indiana Dept. of Workforce Development Purchase Order No. 10 North Senate Ave., SE 106 Terms Indianapolis, IN, 46204 -2277 Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO 9!3110 133438 Benefit char e AU-01 0 Amount 1,315.00 PAY AL! -'.OUT OF 10 <1'per Michael 1. 1/20/08 Total I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance 1,315.00 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 1,315.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT AMOUNT Board Members Dept TITLE 1125 133438 4110000 1,315.00 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 23 -Sep 2010 Signature 1,315.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund 1 /OUCHER NO. WARRANT NO. ALLOWED 20 IN Department of Workforce Development Benefit Administration IN SUM OF 10 North Senate Avenue Indianapolis, IN 46204 -2277 $292.47 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1207 133438 -000 41- 110.00 $292.47 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, September 16, 2010 :Z a' Director, Brooks ire Golf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund 1 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)) 08/31/10 133438 -000 Unemployment $292.47 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 I VOUCHER 102856 WARRANT ALLOWED 1'46500 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 090310 01- 4080 -12 $390.00 Voucher Total $390.00 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 9/23/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/23/2010 090310 $390.00 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