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Home My WebLink About196691 04/25/2011 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CHECK AMOUNT: $8,946.56 CARMEL, INDIANA 46032 DEVELOPMENT ATTN ACCT RECV 101 N SENATE AVE CHECK NUMBER: 196691 INDIANAPOLIS IN 46206 -0647 CHECK DATE: 412512011 DEPARTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4110000 0311 1,560.00 FULL TIME REGULAR 1125 4110000 0311 3,932.56 FULL TIME REGULAR 1192 4110000 0311 2,340.00 FULL TIME REGULAR 1207 4111000 0311 1,114.00 PART -TIME 133438 -1 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT BENEFIT ADMINISTRATION, :10 NORTH SENATE AVENUE. INDIANAPOLIS, IN 46204 -2277 Toll free 1 -80o- 8916499 Marian County 232.7436 :STATEMENT OF BENEFIT CHARGES (FORM 535) CONFIDENTIAL RECORD PURSUANT TO IC 22-4 -19.6, IC 4 -1.66 Page. 3 CITY OF i CAIZ.MEL Accou 01N :CLERK TREASURER LOCATION NUMBER 13343&' -U00 ONE CIVIC S(21 REPORTING MONTH' MAR, 2011 CARMEL.ZN 46032 -256:4 NETCHARGES $8 94 6_• 86 POSTING DATE APR 0:1, 2013 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 information which could disqualify the claimant. SOC IA L BENEFIT PAID FOR SECURITY YEAR END CLAIM RANSACTION WEEK AMOUNT NUMBER EMP.LOYEE'S NAME DATE LEVEL DATE ENDING 1. 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-youvaccount during the "reporting "month.' At.the end of the "posting" month, you will receive a Reimbursable' Bill (Form 11 067) for. these charges and any:previous'liability stilLoutstanding. *a NEW CHARGES FOR THE REPORTING MONTH 03/11: T A WEDDINGTON epo,Z 12/31/11 REG 03%06/11 02/19/11 390,00 *x* CONTINUE ON NEXT PAGE An in the ACO columndenotes a charge resulting from an acquisition of another business. Account/Location Number: 133438 -•000 Reporting Month: MARCH, 2011 'Page 2 Emptoyer Name: CITY OF CAMEL BENEFIT- PAID FOR SECURITY YEAR END CLAIM RANSACTCON WEEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING ACS CHARGED NEW CHARGES FOR THE REPORTING MONTH 03/11 T A WEDDINGTON 12/31/11 REG 03/28/11 03/26/11 390.00 TOTAL NEW CHARGES FOR THE REPORTING MONTH 03/11 8,946.56 TOTAL AMOUNT OF NET CHARGES 8,946.56 The following charge(s) are POTENTIAL credits to your account. A determination was made and you were found not liable for these charges. But because you have chosen to make payment in lieu of contributions for Unemployment Insurance, your account cannot be credited for these charges unless or until the claimant(s) refund the overpayment. Your account will be credited as the claimant refunds the overpayment in full or in monthly installments. 307 -06 -3124 J N SPENCE 10/23/10 EB 01/22/11 86.40 END OF BENEFIT CHARGE STATEMENT I I v 1.: d ,e €nurrd r�l J ''li lt I tl I i,y s I r Y t �I Y sh r" i I Y `Y I �yl 11 I N r �I i 11: 1Y INlrrkw!��b� %�a'. u� J II W.IIG,ii �,I y i 1 4• �,r F i LI��I �6 s it Ilea I k a Ir i ,r I<�� d 4�� j V„ ns� 0. I h• ,;�la� li 4r,� I �I 1 l 4 11 a +pe; s €o, '`"ryq "pl' ry�,t. ;.�Ml�l P tI {�s e iyy ry N it I i i1�1 I >il Ip�r��.. k� I I o4tl,� �u�,iii s ��a y a dY i Sly I ;f snJ/sli y I iu x A .k' °7J: w 5,,,,.� te e' .r t� 1 €I 4'.' a En ,�7 1 1 1 ul ai'YIA' ry a I a elT1 r �F r t7r I il.€ e. I r e, IN h� �?��t111 I I,li,, I it 3' il�h s ry sA I�'hr Et'I do! S�� I �„ry n' '1� �C"I ��I�� I I �i I i� C. La dl ,ry I k I a49, ��M ✓i I ,`.l" /e Itrf� ��I��wliC€riiY I I�lal �Ik� �U NI d I�Ns IIp1 I,ryJldlfil II�!N1 Vii, il�"'I€pu ll', �halb x lf„ryl ,x� alP 41'1 s� w ��i, I��(� r, E llydll mi II� sf �dIiIG'I;•�F u� 1 a I h� I F� yy�� 1i Cllh A la r r I n t d;: it I I� 1lww l -.o� I iki•' i t� i�l M ary al �yll °t t�l�a�u��9II��I 'k�II�I��lil�IR��2 i€Ik'7idl' �'NI�I�I lII YII �a Ilil 3 {ti �{I Y 4 iallrr 1 fad ry� 1a I€ gg l fY IN v Ia, rlry �l 1': a C ryd aff i t i a� 5, iE �i e•, mil tJ i f''IJ�'7, �a' i''.I I .,1Ik, a�'r<��N4 s €i"; ill l�Il II egii 7� k �lry��rr -0a l:e .l HI r ,a� 11 ��i ,.a f.'' it x�; ai 4 �,q ,li .`Pir J �sli 4.. jL ��l INS; 4 :y' �Ih I' f�l��. ��I �.P M .slip I �II is''�1,s Jrij r�G ryl,, �esl'.M ia*fl s .k.x to .6'�tly��S�'a'r+�e%+.JIV�I i:e��l�4 hd�� 3 1 An in the ACQ 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 $1,114.00 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1207 133438 41- 110.00 $1,114.00 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 Tuesday, April 19, 2011 Director, Brookshi er olf Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 19 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)) 04/01/11 133438 Unemployment $1,114 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordanc with IC 5- 11- 10 -1.6 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Indiana Department of Workforce Development Benefit Administration IN SUM OF 10 North Senate Avenue Indianapolis, IN 46204 -2277 $2,340.00 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members 1192 I I _41- 100.00 1 $2,340.00- 1 hereby certify that the attached invoices), or bills) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Friday, April 22, 2011 ire 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)) 04/18/11 Unemployement Trudy $2,340.00 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 invoices) or bill(s)) PO Amount 4/1/11 133438 Unemployment charges Mar'11 3,932.56 Total 3,932.56 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 1 20 Clerk- Treasurer k Voucher No. Warrant No. 146500 Indiana Dept. of Workforce Development Allowed 20 10 North Senate Ave., SE106 Indianapolis, IN 46204 -2277 In Sum of 3,932.66 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT. AMOUNT Board Members Dept TITLE 1125 133438 4110000 3,932.56 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 21 -Apr 2011 Signature 3,932.56 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund