HomeMy WebLinkAbout200054 08/03/2011 CITY OF CARMEL, INDIANA VENDOR: 00352820 Page 1 of 1
R ONE CIVIC SQUARE LONNIE PATTON
CARMEL, INDIANA 46032 CARMEL UTILITIES CHECK AMOUNT: $30.00
CARMEL UTILITIES CHECK NUMBER: 200054
CHECK DATE: 8/312011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 30.00 OTHER EXPENSES
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CITY OF CARMEL Expense Report (required for all travel expenses)
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2010 mileage reimbursement rate is 50 cents /mile
EMPLOYEE NAME: Lonnie Patton DEPARTURE DATE: na TIME:
DEPARTMENT: Utilities /Sewer RETURN DATE: na TIME:
REASON FOR TRAVEL: Wastewater Operator Certification Renewal DESTINATION CITY:
EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT _X_ TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Lodging Meals Misc. Total
Air -fare Car Rental I Other Parking Breakfast Lunch Dinner Snacks Per Diem
6129/11 Wastewater Operator Class III renewal $30.00 $30.00
$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
$0.00
$0.00
0.00
Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.00 1 1 4
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 ER06 Revision Date 7/20/2011 rage 1
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PNC Online Banking
Date Description Amount Account
07/05/2011 Check 1347 $30.00 4622514047
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Your Wastewater Treatment Plant Operator certification, number WWO 18293, is enclosed.
IMPORTANT CERTIFICATION INFORMATION.
ADDRESS CHANGE: It is your responsibility to notify the Indiana Department of Environmental Management of any
change of address. You may e -mail us at tfuilerw(a`?idem.in.tov or fax to (317) 232 -8637 or call (3 f 7) 233 0470.
NAME CHANGE: A name change request must be submitted in writing. Mail to: Department of Environmental
Management, Office of Wafer Quality Mail Code 65-42, 100 N. Senate Ave., Indianapolis IN 46204 -2251 or you can
fax to (3 17) 232 -8637.
CONTINUING EDUCATION: Prior to renewing your certification, you are required to obtain at least the following
continuing education contact hours from 1DEM- approved (raining courses based on the classification of your certification:
Classes I -SP and A -SO: 5 contact hours; at least 3.5 of which must be tectmical flours
Classes I, 11, A and II: 10 contact hours; at least 7 of which must be teclnical hours
Classes III, IV, C and D: 20 contact hours; at least 14 of which must be technical hours
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Departmt orI"Env+
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t Your certification will expire on 06/30/2013. If you have any
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p lease questions, contact Ton l Fuller- White at 17) 233 -(1479 or
t o hl hlnctiinat 22�1� 's^ 't'3,.r
email 1tullerw0Wem.in. <,ov
aw �I�tWasWte"'ater 'Op�ra�for�Class�III
Please retain this 1icensure Information sheet so that you will have
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the Program address, telephone number, and your certificate
ut W018293 �0,7 l f iIOG 30 If number available should you need to contact the program office.
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VOUCHER 115523 WARRANT ALLOWED
T9960 IN SUM OF
PATTON, LONNIE
WASTEWATER
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
0629611 01- 7042 -06 $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
T9960
PATTON, LONNIE Purchase Order No.
WASTEWATER Terms
Due Date 7/25/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/25/2011 0629611 $30.00
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
Date 6faer