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Home My WebLink About195796 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CARMEL, INDIANA 46032 DEVELOPMENTATTN: ACCT RECV CHECK AMOUNT: $10,206.04 101 N SENATE AVE CHECK NUMBER: 195796 INDIANAPOLIS IN 46206 -0847 CHECK DATE: 3/29/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4110000 2,340.00 FULL TIME REGULAR 1125 4110000 4,007.39 FULL TIME REGULAR 1192 4110000 1,170.00 FULL TIME REGULAR 1207 4111000 2,404.00 PART -TIME 1125 R4110000 28036 284.65 UNEMPLOYMENT FEES 133438 -1 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT BENEFIT ADMINISTRATION, 1 D NORTH SENATE AVENUE, INDIANAPOLIS, IN 46204 -2277 Tall free 1-800-691-6499 Marlon County 232 -7436 STATEMENT OF BENEFIT CHARGES (FORM 535) CONFIDENTIAL RECORD PURSUANT TO IC 22.4 -19 -6, IC 4 -1 -66 Page CITY OF CARMEL ACCOUNT/ ATTN CLERK TREASURER LOCATION NUMBER 133438 -000 ONE CIVIC SQ REPORTING MONTH FEB, 2011 CARMEL IN 4LO32 -2584 NET CHARGES $10,206.04 I POSTING DATE t�R 0 6 2011. 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 rinformation which could disqualify the claimant. SOCIAL BENEFIT PAID FOR SECURITY YEAR, END CLAIM TRANSACTION WEEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING AC 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 02/11 M D CALVERT 12/24/11 REG 02/04/11 01/29/11 258.00 CONTINUE ON NEXT PAGE An in the ACQ column denotes a charge resulting from an acquisition of another business. AccounVLocation Number: 133438 —000 Reporting Month: FEBRUARY, 2011 Page 2 Employer Name: CITY OF CARMEL SO CIAL BENEFIT PAID FOR SECURITY YEAR ENO CLAIM RANSACTION WEEK AMOUNT NUMBER I EMPLOYEE'S NAME DATE LEVEL DATE ENDING A CHARGED NEW CHARGES FOR THE REPORTING MONTH 02/11 T A WEDDINGTON 12/31/11 REG 02/13/11 02 /12/11 390.00 TOTAL NEW CHARGES FOR THE REPORTING MONTH 02/11 10,206.04 TOTAL AMOUNT OF NET CHARGES 10,206.04 END OF BENEFIT CHARGE STATEMENT Lj 0 An in the ACQ 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 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 3!6111 133438 Benefit charge Feb'11 28036 F 284.65 316111 133438 Benefit charge Feb'11 4,007.39 Total 4,292.04 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. 146500 Indiana Dept. of Workforce Development Allowed 20 10 North Senate Ave., SE 106 Indianapolis, IN 46204 -2277 In Sum of 4,292.04 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT AMOUNT Board Members Dept TITLE 28036 F 133438 4110000 284.65 1 hereby certify that the attached invoice(s), or 1125 133438 4110000 4,007.39 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 f 24 -Mar 2011 Signature 4,292.04 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 $3,373.54 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1207 133438 -000 41- 110.00 $969.54 1 hereby certify that the attached invoice(s), or 1207 133438 -000 41- 110.00 $2,404.00 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 28, 2011 Director, Brook hire 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. 199E 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)) 02/06/11 133438 -000 Unemployment $969.5 03(06111 133438 -000 Unemployment $2,404.0 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 N ALLOWED 20 Indiana Department of Workforce Development Benefit Administration IN SUM OF 10 North Senate Avenue Indianapolis, IN 46204 -2277 $1,170.00 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1192 41- 100.00 $1,170.00 1 hereby certify that the attached invoice(s), *or I I 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 MondA, Mar 2011 erector 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)) 03/17/11 $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 20 Clerk- Treasurer