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Home My WebLink About198572 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 146900 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF ENVIRONMENTAL M 'HECK AMOUNT: $30.00 CARMEL, INDIANA 46032 100 N SENATE AVE MAIL CODE 66 -35 CHECK NUMBER: 198572 INDIANAPOLIS IN 46204 -2251 CHECK DATE: 6/22/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 60711 30.00 OTHER EXPENSES Indiana. Department ofEnvironmcntal Management 100 N. Senate Avenue Invoice Number: 4130856 Mail Code 66 -35 Renewal Fee: $30.00 Indianapolis, IN 46204 -2251 Money Rcceipl 9 (Office Only) Tune 2, 2011 Certificate Number: DS987856 Expiration Date: 06/30/2011 STEVE L. COOK Grade: DSL 345D WI ST 131 ST STRI=ET Obtained By: Examination Carmel IN 46074 Login ID: DS987856 Password: 583445 INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT ffaler Works Operator Cet•lilrcalion Renewal Fee Staleinent Our records indicate your Water Works Certificate- No, DS987856, Grade DSL for a class DSL Witter Distribution System expires on 06/30/2011. You are required to obtain 15.00 contact hours of continuing education for renewal. Our records indicate that you currently have accuntt fated 38.75 contact hours towards renewal. (This may not reflect hours R)r courses recently attended.) Note: If'you have not recenlly attended an approved course, and you do not have. the required t.itnnbcr of hours, you need to attend courses prior to .tiny 1, 201 1. After this date you are on expired status and are not a valid certified operator. You do have unti'I .fitly I, 2012 to get your continuing educatiolt hours and renew your certification. Failure to renew by auly 1 2012 will result intern—dilation of your certification. and YOU will have to retest. Online Renewal Online renewal is available 24 hours a day. 7 days a week at The cost for the online renewal is $30.00 plus an additional processing fee li)r each certification renewal. The forms ol'paymeut accepted online are Visa MasterCard, Discover credit and debit cards. Login 11) and Password are listed above. Mail Renewal -To renew through the mail please fill out the bottom section and return this entire letter with $30 fee payment to the remittance address listed. Be sure to sign and date in spaces provided. Make a photocopy for your records. Please note that renewal through the mail will take lonL�cr than an online renewal. If you have other drinking water certifications due renewal, you can combine them in one mailing with a fee payment that covers all of them. For example: (3 renewals x S30 /per renewal) S90 combined lec. Remit Payment to: Indiana Department of Environmental Management Cashier's Office Mail Code 50-IOC 100 N. Senate Avenue ludianaN lis, IN 46204 -225 1 Cancel Certification If you du not want to renew this certification, please write "CANCEL" on this lbrtn, sign and date in spaces provided, and mail to the remittance address listed. FILL OUT BOTTOM PORTION RETURN ENTIRE LETTER WHEN RENEWING BV MAIL OR CANCELLING If this certification was obtained by Examination and the tacility you are employed at has changed please add your new employer in the space provided. NOTE if this certification is Grandfathered or Site Specific, it is valid only for the location below. Operator Number: DS987856 Invoice Number: 4130856 PWS Name PWS ID CARMEL WATER DEPT 5229004 Address Change: 3 S o e-r Home Phone Number 3 r 6 I Wnt'k Phone Number: ,33 Operator Si nature: Date: 0(0 Ul' VOUCHER 111470 WARRANT ALLOWED TIDEM IN SUM OF I D E M Pj 1�f\f 100 N SENATE AVENUE �iy INDIANAPOLIS, IN 46204 -2251 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 60711 01- 6040 -05 $30.00 Voucher Total $30.00 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 TIDEM IDEM Purchase Order No. 100 N SENATE AVENUE Terms INDIANAPOLIS, IN 46204 -2251 Due Date 6/13/2011 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 6/13/2011 60711 $30.00 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 Officer