164545 10/14/2008 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE
CARMEL. INDIANA 46032 DEVELOPMENT CHECK AMOUNT: $194.59
to,r PO Box 847 CHECK NUMBER: 164545
INDIANAPOLIS IN 46206 -0847
CHECK DATE: 10/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1125 4110000 194.59 FULL TIME REGULAR
s�
The faltowin;g items apply to your benefit
charges posted ink .ruNE. o 200$ ACCOUNT NUMBER: 133438
ACTIVITY SUMMARY BENEFIT CHARGES INTE=REST PENALTY TOTAL LIABILITY
FOR'THE PERIOD
PREVIOUS BALANCE 370:84 7.42 37.08
PAYMENTS 370.84CR 7,42CR 37.08CR N"
r
ENDING BALANCE .00 00 .00 .00
The following items apply to your benefit.
charges posted in JULY of .2008 ACCOUNT NUMBER: 133438
ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL: IO
FOR THE E PERIOD
PREVIOUS BALANCE 1 15:b0 156.00
PAYMENTS };560:00CR 15.60CR 156.DOCR 17"" PTV
OC T
BY:
a
ENDING.BALANCE .00 00 .00 .00
THE TOTAL LIABILITY BALANC €`IS: LOCATED ON THE LAST PAGE
OF THIS BILL.
Additional interest will accrue at a rate of 1% per month and a one time penalty of 10% will be assessed on any
outstanding benefit charges after She payment due date.
If the liability is not paid in full, the Director may file with the clerk oUthe circuit court in:your county, a warrant directing the
sheriff to levy upon.assets, in sufficient quantity to satisfy the amount of the warrant'plus damages in the amount of 10
plus penalties and interest.
If you have any questions, please call (800) 891 -6.499 or (317) 232 7395 and ask for Collections.
R EIMBURSABLE BILL A 'NUMBER 1 PAGE: 2 OF 2
DATE: OCTOBER 01, 2008
The following ,items apply -to your benefit AGCQUNT NUMBER. 13343:8
charges posted in AUGUST 'of .2008
ACTIVITY SUMMARY BENEFIT.CHARGES INTEREST PENALTY TOTAL'tIABILlTY
FOR THE; PERIOD'
PREVIOUS BALANCE
2;643.54 DO .00 s
p 6 4 t ft had
PAYMENTS 2,468:23CR. 00 .00
ASSESSMENT Or INTEREST /PENALTY 1.75 17.53 �y
i s
for
ENDING BALANCE 175.31 1.75 17.53 r( 194.59
Yvl punt"
d-i cL12`L rc-cei vc
The fo.1low,1ng items apply to your lbenef•it NUMBER: ACCOUNT' 13343$ i ir jCe
charges posted in SEPTEMBER of 2008
TOTAL LIABILITY
ACTIVITY SUMMARY BENEFIT CHARGE'S INTEREST PENALTY F I h THE PERIOD
PREVIOUS BALANCE .00 00' 00
—ASSESSMENT OF BENEFIT CHARGES 1,890.00
t
ri RF
s
mat:
EN61NG BALANCE 1,890.00 .00 _00 1;890 00
THIS IS YOUR TOTAL LIABILITY. PAYMENTS MAILED AFTER THE 20TH"
OF THE MONTH. MAY NOT ;BE REFLECTED ON THIS BILL. PLEASE $2,084.59
PAY THIS.AMOUNT NO LATER OCTOBER 3 1, 2008
Additional interest will accrue at a rate: of 1% per month and a one time penalty of 10% will be assessed on any.
outstanding benefit charge s,after the payment due date.
If the liability is not paid in full, the Director may,file with the clerk of the circuit court in yo.ur a warrant directing the
sheriff to levy upon assets in sufficient q uantity to satisfy the amount of the, warrant plus damages in the amount of 10
plus penal ties.and interest,
If you have any questions, please call (800) 891-6499 or (317) 232' -7395 and ask for Collections.
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.
Indiana Dept. of Workforce Development Terms
10 North Senate Ave., SE106 Date Due
Indianapolis, IN 46204 -2277
e
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/3/08 133438 Benefit charges 194.59
Total 194.59
1 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
Voucher No. Warrant No.
Indiana Dept. of Workforce Development Allowed 20
10 North Senate Ave., SE 106
Indianapolis, IN 46204 -2277
In Sum of
194.59
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT AMOUNT Board Members
Dept TITLE
1125 133438 4110000 194.59 i 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
6 -Oct 2008
44 �C
Signature
194.59 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund