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HomeMy WebLinkAbout198462 06/22/2011 a CITY OF CARMEL, INDIANA VENDOR: 052000 Page 1 of 1 ONE CIVIC SQUARE CRAIG CARTER CHECK AMOUNT: $34.17 CARMEL, INDIANA 46032 109 EMERALD LANE NOBLESVILLE IN 46060 CHECK NUMBER: 198462 CHECK DATE: 6/22/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 34.17 EMPLOYEE PENSIONS B /t•( OF CARM�. CITY OF CARMEL Expense Report (required for all travel expenses) R �NDIAN� 2010 mileage reimbursement rate is 50 cents /mile EMPLOYEE NAME: Ernest C. Carter DEPARTURE DATE: na TIME: DEPARTMENT: Utilities /Sewer RETURN DATE: na TIME: REASON FOR TRAVEL: WWTP operator certification renewal DESTINATION CITY: EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT _X_ TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other 9 Breakfastj Lunch Dinner Snacks Per Diem 6/8/11 WWTP operator certifcication renewal $30.00 $30.00 6/8/11 Enhanced fee $2.50 $2.50 6/8/11 Instant fee $1.67 $1.67 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00 Total $0.001 $0.00 1 ).001 $0.00 $0.00 $0.001 $0.00 $0.00 $34.17 DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget. Director Signature: Date: City of Carmel Form 9 ER06 Revision Date 6/9/2011 Pagel Indiana Department of Environmental Management IDEM 100 N. Senate Avenue Mail Code 65 -42 Indianapolis, IN 46204 -2251 1986' Ernest C. Carter 109 Emerald Lane Noblesville IN 46060 WASTEWATER TREATMENT PLANT OPERATOR RENEWAL APPLICATION License Class Wastewater Operator Class IV May 12, 2011 Certification WW011425 Expiration Date: 06/30/2011 Renewal Fee: $30.00 Login Id: WW011425 Password: 492108 Current Continuing Education Hours Earned: General 0.00 Technical 21.50 Total 21.50 I am currently the responsible charge operator who signs the monthly reports (MRO /MMR) at the following facilities: Facility Name Hours/Week Permit# Cit f Carmel Wk17 d Z Address Change: I Home 'I Current Phone J 1 3 XrWork Operator Signature: Date: Your wastewater treatment plant operator certification expires 06/30/2011. After this date, you cannot be the operator in tesp "orisioie cPiarye Uia wustarn;a.ertre.;2.--ert -.l ant-::.^. 4i!- ±sr- cectifiaztion_is_renPwed. You must meet the continuing education requirement as shown below: Classes I -SP, A -SO 5 hours earned between 7/1/2009 6/30/2011 from IDEM approved course with at least 3.5 of those hours from courses designated as "technical." Classes I, II, A, B 10 hours earned between 7/1/2009 6/30/2011 from IDEM approved course with at least 7 of those hours from courses designated as "technical." Classes III, IV, C, D 20 hours earned between 7/1/2009 6/30/2011 from IDEM approved course with at least 14 of those hours from courses designated as "technical." Online Renewal Online renewal is available 24 hours a day, 7 days a week between May 1, 2011 and July 1, 2011 at https: /mylicense.in.gov The cost for the online renewa! i"s $30.00 plus an additional $4.17 in processing fees. The forms of payment accepted online are Visa, Mastercard, Discover credit and debit cards. Login ID and Password are above. Mail Renewal If you wish to renew by mail, fill out the responsible charge information, and send this form with your $30 renewal fee to: Cashier Mail Code 50 -10C Indiana Dept. of Environmental Management, 100 N. Senate Avenue, Indianapolis, IN 46204 -2251. Make checks payable to IDEM. Should you have any questions or concerns about the renewal process, please contact Tonja Fuller -White at (317) 233 -0479 or by e-mail at tfullerw caidem.in.gov Welcome to Indiana Licensing Page 1 of 1 Online Licensing Payment Receipt This page serves as your receipt for this transaction. Your payment will appear on your credit card statement as "State of Indiana License Fee" or something similar. To maintain this page for your records, you may print this page by clicking the "Print Receipt" button below. What to do next? Renewal Check back on the MyLicense site in 24 48 hours to see if your expiration date was extended. o If so, you will receive your updated wallet card shortly. If not, this may mean that there is a problem with your certification renewal. You may contact program staff at tfullerw@idem.in.gov Payment received thank you. Licensee: Ernest C. Carter License Number: WWO11425 Authorization Code: 060538 Received Date: 6/8/2011 1:50:53 PM Transaction ID: 7453038 Credit Card Number: XXXX XXXX XXXX 5334 Fee Amount: $30.00 Enhanced Fee: $2.50 Instant Fee: $1.67 Total Payment: $34.17 Print Receipt Renew Another License Lo9out https: /mylicense .in.gov /eGov /PaymentResult.aspx ?answer processed &credit card_numbe... 6/8/2011 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 52000 CRAIG CARTER Purchase Order No. 109 EMERALD LANE Terms NOBLESVILLE, IN 46060 Due Date 6/13/2011 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 6/13/2011 060811 $34.17 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 O di A r VOUCHER 115239 WARRANT ALLOWED 52000 IN SUM OF CRAIG CARTER 109 EMERALD LANE NOBLESVILLE, IN 46060 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 060811 01- 7042 -05 $34.17 Voucher Total $34.17 Cost distribution ledger classification if claim paid under vehicle highway fund