HomeMy WebLinkAbout191781 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 00351721 Page 1 of 1
ONE CIVIC SQUARE JAMES PAGE
CARMEL, INDIANA 46032 CHECK AMOUNT: $1,560.00
CHECK NUMBER: 191781
CHECK DATE: 11/1012010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 4128000 SU 10 1,560.00 TUITION REIMBURSEMENT
Martin University
FINAL Grade Report
11/2/2010 SU -10 Page 1
Page, James E Student ID:
3961 N Broadway
Indianapolis IN 46205 Maior Advisor
URBAN MINISTRY STUDiEBDliver, Claude
CourselD CourseName Credits Grade GPAHours GradePoint
UMS 582 60 Religious Education Program Development 3.00 A 3.00 12.00
T ItY mpted Earned GPA Hours Grade Points GPA Comp Rate
Term: 3.00 3.00 3.00 12.00 4.00 100.00
Cumulative: 66.00 129.00 66.00 249.45 3.78 195.45
Martin University
P.O. Box 18567
Indianapolis IN 46218
Phone: 317- 543 -3248
Fax:
Statement and Schedule
11/02/2010
James E Page Student ID:
3961 N Broadway College Level: Masters
Indianapolis IN 46205 Student Level:
Current Schedule: SU -10
Course Course Title Status Credits Grade
UMS -582 -60 Religious Education Program Development Official 3.00 A
3.00
Previous Balance: $0.00
Term °Date' Descri tiori rt Y Debits iGrecits x
SU -10 4/16/2010 Safety and Public Service $100.00
4/16/2010 Student Activity
4/16/2010 Tuition $1,560.00
4/16/2010 Computer Technology Fee 0
11/2/2010 Tuition Payment Charge $1,720.00
HOIdDate HoldCategory HoldDescription Statement Total: $0.00
03/09/2009 Bursar Office Student has an account balance. PendingTotal: $0.00
Overall Total: $0.00
Notes: Page 1 of 1
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 J G 4l
:Department 1;l)AyyM�r 0 s I s�i%'Ij SSN / Date _3 -2 C/ 2 OQ
Educational Institution*
Name of Course" [A A C+id2A !f t'��tll� t� UM S �c�Z
Semester/Year of Course S�tw111t.E Ul( �i� l i o
Lunderstand that to receive reimbursement for this course, I must submit evidence of payment for the course and
a copy of m yfinal grade. To receive reimbursement for books, I must submit the book list for the course and an
original itemized receipt for all books purchased. The amount of the reimbursement is subject to the terms of
Section "2 -59 of Carmel City Code.
I further understand that the tax status of reitbursement payments is subject to federal law, which may change
from time to time. If i leave my employment with the City within one (1) year of the end of this course, I will
reimburse the City according to the terms 'of Section 2 -59 of Carmel City Code.
Employee Signature r r Date 1: 2010 p ap 0
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 6q- p
Part III (to be completed by Director of Human Resources)
Final Approval t�._�__ Date _L- 10
If denied, reason for denial
(After final approval is given or denied, a copy of this application form will be returned to the applicant and the
appropriate department head.)
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.
An application will not he considered complete unless a course description from the school's literature is attached.
VOUCHER NO. WARRANT NO.
ALLOWED 20
James Page
IN SUM OF
$1,560.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel IS Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1202 I SU 10 I 41- 280.00 I $1,560.00 1 hereby certify that the attached invoice(s), or
I 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, November 08, 2010
D i rector,,l5
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 Number (or note attached invoice(s) or bill(s))
11/08/10 SU 10 $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 [C 5- 11- 10 -1.6
,20
Clerk- Treasurer