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HomeMy WebLinkAbout159808 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: 361329 Page 1 of 1 ONE CIVIC SQUARE CLAY CAMPBELL 1, CARMEL, INDIANA 46032 9003 MAX COURT CHECK AMOUNT: $1,658.80 FISHERS IN 46037 CHECK NUMBER: 159808 CHECK DATE: 5/28/2008 r DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM OUNT DESCRIPTION 601 5023990 052308 1,036.75 OTHER EXPENSES 651 5023990 052308 622.05 OTHER EXPENSES I I City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head rp for to commencement of course.) Employee Name 0,tGt-e Cj- Pjt�/I Department IIIo�G{ SSN ` 7 Hire Date Educational Institution* Th� i cw�q l�, YyY_Cdc'_ U, TkUi'CA U'_1iS NameofCourse pol Aie v� ]1 WAe-y\ 5, 07 %iJ►Y 1 irtln �j�u -1iStn Starting Date of Course (month /day /year) 0 V b By signing below, I signify that I understand the following: The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -59. To receive reimbursement for tuition, I must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit the book list for the course and an original itemized receipt for all books purchased. If I leave City of Carmel employment sooner than one (1) year after the end of this course, 1 will repay the City in full for its tuition and book reimbursements for this course. The tax status of reimbursement payments is subject to federal law, which may change from time to time. Employee Signature Date y6 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 Sect' n 2 -59 of Cannel City Code. Department Head Signature Date Part III (to be completed by Director of Human Resources) y Final Approval G Date If denied, reason for denial 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 or an equivalent regional accreditor. An application will not be considered complete unless a course description from the school's literature is attached. City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head np for to commencement of course.) Employee Name Department W CJt VI e G, SSN )) Hire Date 06 Educational Institution Name of Course g�ic, &1 &W fit�1' G1ry If Q v V o5 Ij 0 4 Starting Date of Course (month /day /year) By signing below, I signify that I understand the following: The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -59. To receive reimbursement for tuition, I trust submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit the book list for the course and an original itemized receipt for all books purchased. If I leave City of Carmel employment sooner than one (1) year after the end of this course, I will repay the City in full for its tuition and book reimbursements for this course. The tax status of reimbursement payments is subject to federal law, which may change from time to time. Employee Signature Date 01' 04 Part II (to be completed by Department Head) (Submit to Human Resources) By signing below, 1 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 Cannel City Code. Department Head Signature Date l ah 2 y= Part III (to be completed by Director of Human Resources) Final Approval �.n�tL_.. Ck _0 Date g o If denied, reason for denial 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 or an equivalent regional accreditor. An application will not be considered complete unless a course description from the school's literature is attached. I View MY 'Grades Pagel of 2 Go to Bottom i Student Center 55 Clay Campbell Search for Classes I Academic Planning Academics Grades View My Grades Spring 2008 1 Undergraduate I IUPUI change term I Class Grades Spring 2008 Official Grades Class Description Units Grade Grade Points 'ENG_W 132 ELEMENTARY COMPOSITION 2 3.00 A- 11.100 INTENSIVE BEGINNING SPAN -S 131 5.00 B 16.500 S PANISH I o Term Statistics Spring 2008 From Combined From Transfer Term Cumulative i Enrollment Credit Total Total To G rade Points j 27.600 27.600 181.700 Graded units towards GPA 8.0001 8.000 66.000 Graded units not for GPA 50.000 IIn progress units F GPA 3.450 3.450 2.753 *'K GPA Total Grade Points Graded units towards GPA k Transfer Credit column information reflects the Transfer, Test and Special /Other Credit for this term. Statistics represent the grade points and hours as evaluated by the academic policies of Your academic school /program. Go to "My Academics Grades" to run an Indiana University unofficial transcript to view your Indiana University GPA and Hours in addition to your Student Program statistics. Printer Friendly Page Search For,_Classes Academic_ Planning My_Acadgyn cs_& Grades Student Center to Top https:Hiuself.lu.edu /psc /SSERV/ SISSELFSERVICE /HRMS /c /SA_LEA -RNER SERVICES.SSR SSENRL... 5/8/2008 QUIOAY(R) Print Payment Receipt Page 1 of 1 Payment Receipt This is your receipt. Your payment has been submitted. Thank you. Confirmation Number: 2350809 Payment Date: Apr 30, 2008 at 8:43 AM, EDT Effective Date: Apr 30, 2008 Primary User Id: 0001963789 Primary User Name: Clay Samuel Campbell Account: Indianapolis Payment Amount: $1,992.27 Cardholder's Name: Sara Campbell Payment Method: Address Info: 9003 Max Court Fishers, IN 46037 Contact Info: (317)441-8764 (daytime phone) Your payment has been received by Indiana University. https:// qulkpayasp. com/ iu/ qp/ epay /preparePrintPaymentReceipt.do 4/30/20OR INDIANA UNIVERSITY P IUPU1 Office O Box 6020 f the Bursar Account Statement Statement Date: 01/02/08 Page 1 of 1 Due Date 01/15/08 Billing Reference: IN BILL# Previous Balance 1,592.27 University ID: 0001963789 Minimum Due 985.89 Student Name: Campbell,Clay Samuel Total Due 1,948.77 Statement notification sent to clscampb @iupui.edu Charges and Adjustments 12/23/07 Activity Fee 66.14 12/23/07 Technology Fee 177.10 12/23/07 General Services Fee 10.00 12/23/07 Resident Undergraduate Fees 1,658.80 12/23/07 Athletic Development Fee (SAF) 36.73 TotalCharges and Adjustments: 1,948.77 Payments and Financial Aid 12/06/07 Payment by Web Credit Card 700.00 C R 12/20/07 Payment by Web Credit Card 892.27 C R Total Payments and Financial Aid: 1,592.27 CR L 71 Messages Paying at least the minimum payment amount due as indicated will enroll you in the installment plan program. There will be a non refundable Please see a copy of the IUPUI Bursar newsletter at www.bursar.iupui.edu The University reserves the right to restrict services, deny registration, impose iaie fees, assess returned item service charges, terminate any If paying by check we may choose to convert your paper check into an electronic transaction. The amount of your check may appear as an electronic You agree that if another person submits a check on your behalf, that individual is considered your agent and was provided with the information on IU now has an Emergency Notification system!! To ensure you receive critical notifications, please visit OneStart, www.onestart.iu.edu, to review Quicker refunds: Save time and add convenience. Avoid mail delays. Please visit OneStart (www.onestart.iu.edu) and sign up to have your refunds An upgrade to the Student Information System (SIS) is coming in February 2008. Stay tuned to OneStart for more details in early January! Make payment online at http: /onestart.iu.edu If mailing payment, include the bottom portion of this statement and make check payable to: INDIANA UNIVERSITY detach IUPUI Office of the Bursar University 1D 0001963789 PO Box 6020 Due Date. 01/15/08 Indianapolis, IN 46206 -6020 Minimum Due 985.89 Total Due 1,948.77 Amount Enclosed Campbell,Clay Samuel 9003 Max Ct Fishers, IN 46038 IUPUI Lockbox Payment Processing Center PO Box 7245 Indianapolis, IN 46206 -7245 AIUINA000196378900000000194877000000000009865 Capital One Online Banking Transaction Details Page 1 of 1 Online Banking SARA CAMPBELL Transaction Details View the details below for your transaction. If you require additional information, please contact the merchant. Detailed Information Transaction Date: April 30, 2008 Post Date:. May 01, 2008 Transaction Description: IUPUI BURSAR WEB PAYME 317- 2742451 IN Charge: $1,992.27 Category: Other Merchant Information: IUPUI BURSAR WEB PAYME 317 2742451 IN CapitalOne.com This site provides information about and access to financial services MEMBER FDIC Home offered by the Capital One family of companies, including Capital One Equal Hou ing Lender 61111 41 Bank (USA), N.A. and Capital One, N.A., members FDIC. Legal Consult your account agreement for information about the Capital One Privacy company servicing your individual accounts. Security Terms and Conditions Capital One does not provide, endorse, nor guarantee and is not liable for third party products, services, educational tools, or other information available through this site. Rea add itional important d isclosu res. ©2008 Capital One Services, Inc. Capital One and Blank Check® are federally registered service marks. All rights reserved. https :Hservicing.capitalone.com /C 1/ Accounts /TransactionDetai1.aspx ?index =l &id= 1632369 &PostedDate... 5/13/2008 VOUCHER 081801 WARRANT ALLOWED T'1008 IN SUM OF CAMPBELL, CLAY ,CARMEL UTILITIES a s. Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 052308 01- 6040 -07 $1,036.75 r l_ �r T Voucher Total $1,036.75 Cost distribution ledger classification if 31aim 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 z performed, dates of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee T1008 CAMPBELL, CLAY Purchase Order No. CARMEL UTILITIES Terms Due Date 5/15/2008 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/15/2008 052308 $1,036.75 hereby certify that the attached invoice(s), or bill(s) is (are) true and ;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 12 C Date Officer City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head ri or to commencement of course.) Employee Name /1 Department UT ,1 r1 �T SSN Hire Date Educational Institution* L1 cWcA, l� r Y U� �J f'. 11 e IA 1 OV a PJ I i Name of Course" 'i 1 J 1 yvi e, 115 ���1Y �Uuv►i5�� Starting Date of Course (month/day /year) 10 V By signing below, 1 signify that I understand the following: The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -59. To receive reimbursement for tuition, I must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit the book list for the course and an original itemized receipt for all books purchased. If I leave City of Carmel employment sooner than one (1) year after the end of this course, I will repay the City in full for its tuition and book reimbursements for this course. The tax status of reimbursement payments is subject to federal law, which may change from time to time. Employee Signature L/ Date I 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 Sect n 2 -59 of Carmel City Code. Department Head Signature Date Q Part III (to be co mpleted by Director of Human Resources) Final Approval tom CSC. Date If denied, reason for denial 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 or an equivalent regional accreditor. An application will not be considered complete unless a course description from the school's literature is attached. City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head rip 'or to commencement of course.) Employee Name Department W C SSN )) Hire Date Educational Institution* V 1" U I Name of Course Starting Date of Course (month/day /year) M By signing below, I signify that I understand the following: The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -59. To receive reimbursement for tuition, I must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit the book list for the course and an original itemized receipt for all books purchased. If I leave City of Carmel employment sooner than one (1) year after the end of this course, I will repay the City in full for its tuition and book reimbursements for this course. The tax status of reimbursement payments is subject to federal lave, which may change from time to time. Employee Signature �j� Date of 04 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 -tithe 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 Cannel City Code. Department Head Signature Date Ida Part III (to be completed by Director of Human Resources) Final Approval /�a�- .3�.� (A �G✓� Date l O If denied, reason for denial 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 or an equivalent regional accreditor. An application will not be considered complete unless a course description from the school's literature is attached. hew My Grades Page 1 of 2 Go to Bottom 1 Student Center 55- Clay Campbell Search for Classes Academic Planning My Academics Grades View My Grades Spring 2008 1 Undergraduate I IUPUI cha te Class Grades Spring 2008 Official Grades !Class Description Units Grade Grade Points ,ENG _W 132 ELEMENTARY COMPOSITION 2 3.00 A- 11.100 SPAN -S 131 INTENSIVE BEGINNING SPANISH I 5.00 B+ 16.500 Term Statistics Spring 2008 From Combined From Cumulative Transfer Term I Enrollment Credi To Total tal ;Total Grade Points 27.6001 27. 600 181.700 I ,Graded units towards GPA 8.0001 8.0R900 66.000 Graded units not for GPA i 1 1 50.000 .In progress units GPA I 3.450 3.450 2.753 GPA Total Grade Points Graded units towards GPA Transfer Credit column information reflects the Transfer, Test and Special /Other Credit for this term. Statistics represent the grade points and hours as evaluated by the academic policies of your academic school /program. Go to "My Academics Grades" to run an Indiana University unofficial transcript to view your Indiana University GPA and Hours in addition to your Student Program statistics. Printer Friendly Page Search For Classes Acade P lannino My Academics Gra Student Centeru }y' Go to Top ttbslhuself. /n, /';,FRV PROs F .T.FC FRNIT(''PfPT?A 4Q /QA TT�AD CRUD,TW! 00 C+CIT, OCTT. Quik-PA Y(R) Print Payment Receipt Page 1 of 1 Payment Receipt This is your receipt. Your payment has been submitted. Thank you. Confirmation Number: 2350809 Payment Date: Apr 30, 2008 at 8:43 AM, EDT Effective Date: Apr 30, 2008 Primary User Id: 0001963789 Primary User Name: Clay Samuel Campbell Account: Indianapolis Payment Amount: $1,992.27 Cardholder's Name: Sara Campbell Payment Method: Address Info: 9003 Max Court Fishers, IN 46037 Contact Info: (317)441 -8764 (daytime phone) Your payment has been received by Indiana University. t ps:// quikpayasp. com/ iu/ qp/ epav /DreDarePrintP,.vn,PntRPr.Pint rin INDIANA UNIVERSITY IUPUI Office of the Bursar PO Box 6020 Account Statement as r o a as d a a s a e o Statement Date: 01102/08 Page 1 of 1 ueDate2 01115/08 Billing Reference: IN BILL# XXX1032141 m P're�viouBalaii�ce 1,592.27 University 10: 0001963789 MmmumDue 985.89 Student Name: Campbelf,C €ay Samuel t s "T,ota Due 1,948.77 Statement notification sent to c€scampb @iupui.edu Charges and Adjustments 12/23107 Activity Fee 66.14 12/23/07 Technology Fee 177.10 12/23/07 General Services Fee 10.00 12123107 Resident Undergraduate Fees 1,6�58.880� 12/23/07 Athletic Development Fee (SAF) 36.73 Total Charges and Adjustments: 1,948.77 Payments and Financial Aid 12/06/07 Payment by Web Credit Card 700.00 C R 12/20/07 Payment by Web Credit Card 892.27 C R Total Payments and Financial Aid: 1,592.27 C Messages Paying at least the minimum payment amount due as indicated will enroll you in the installment plan program. There will be a non refundable Please see a copy of the IUPUI Bursar newsletter at www.bursar.iupui.edu The University reserves the right Lo restrict services, deny registration, impose !ate fees, assess returned item service charges, terminate any If paying by check we maychoose to convert your paper check into an electronic transaction. The amount of your check may appear as an electronic You agree that if another person submits a check on your behalf, that individual is considered your agent and was provided with the information on IU now has an Emergency Notification system!! To ensure you receive critical notifications, please visit OneStart, www.onestart.iu.edu, to review Quicker refunds: Save time and add convenience. Avoid mail delays. Please visit OneStart www.onestart.iu.edu) and sign up to have your refunds An upgrade to the Student Information System (SIS) is coming in February 2008. Stay tuned to OneStart for more details in early January! Make payment online at http: /onestart.iu.edu I£ mailing payment, include the bottom portion of this statement and make check payable toy INDIANA UNIVERSITY detach IUPUI Office of the Bursar R N AM"01 vets [y IQ 0001963789 P O Indi a n apolis. IN 46206 -6020 p Uue Date 01/15/08 }h 3 F!Glinirri015T 985.89 012 MR,w TotaILMU 1,948.77 'AmountEncro`sed Campbell,Clay Samuel 9003 Max Ct Fishers, IN 46038 IUPUI Lockbox Payment Processing Center PO Box 7245 Indianapolis, IN 46206 -7245 AIUINA000196378900000000194877000000000009865 apital One Online Banking Transaction Details Page 1 of 1 Online Banking qq,, SARA CAMPBELL Transaction Details View the details below for your transaction. If you require additional information, please contact the merchant. Detailed Information Transaction Date: April 30, 2008 Post Date:. May 01, 2008 Transaction Description: IUPUI BURSAR WEB PAYME 317 2742451 IN Charge: $1,992.27 Category: Other Merchant Information: IUPUI BURSAR WEB PAYME 317 2742451 IN apitalOne.com This site provides information about and access to financial services MEMBER FDIC !ome offered by the Capital One family of companies, including Capital One E.a.,yl Hoer ir,�7 SFr der Bank (USA), N.A. and Capital One, N.A., members FDIC. egal Consult your account agreement for information about the Capital One rivacy_ company servicing your individual accounts. ecurity erms and Conditions Capital One does not provide, endorse, nor guarantee and is not liable for third party products, services, educational tools, or other information available through this site. Read additional im portant disclosures. ©2008 Capital One Services, Inc. Capital One and Blank Check® are federally registered service marks. All rights reserved. itps: servicing. ca t) italone. com /Cl /Accrnintc /Trancart;nnT)afo;l oo,,, 7;,, 7o„ —i fl.:a i �����r� o..n_ VOUCHER 085507 WARRANT ALLOWED T9005 IN SUM OF CAMPBELL, CLAY CARMEL UTILITIES .q Tor w, Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 052305 01- 7040 -07 $622.05 t Voucher Total $622.05 -,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 T1005 CAMPBELL, CLAY Purchase Order No. CARMEL UTILITIES Terms Due Date 5/15/2008 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/15/2008 052305 $622.05 hereby certify that the attached invoice(s), or bill(s) is (are) true and ;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 Date. Officer