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Home My WebLink About166089 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ti ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE l CARMEL, INDIANA 46032 DEVELOPMENT CHECK AMOUNT: $5,864.95 PO BOX 847 CHECK NUMBER: 166089 INDIANAPOLIS IN 46206 -0847 CHECK DATE: 11/24/2008 DEPARTMENT AC COUN T PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION 101 5023990 728.95 OTHER EXPENSES 1125 4110000 2,016.00 FULL TIME REGULAR 1192 4110000 3,120.00 FULL TIME REGULAR is Z `i_. 13343$ INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT BENEFIT ADMINISTRATION, 10 NORTH SENATE AVENUE, INDIANAPOLIS, IN 46204 -2277 Toll free 1.800-891 -6499 Marian County 232 -7436 STATEMENT OF BENEFIT CHARGES (FORM 535) CONFIDENTIAL RECORD PURSUANT TO IC 22- 4 -19 -6, IC 4 -1 -66 Page I CITY OF CARREL ACCOUNT/ ATTN CLERK TREASURER LOCATION NUMBER 133438 -000 ONE CIVIC SQ REPORTING MONTH OCT, 2008 CARREL IN 46032 -2584 NETCHARGES $5 ,433.02 POSTING DATE —F— Nov -06, 2008 The receipt of this statement (Form 535) does not reopen the question of the claimant's eligibility for unemployment insurance since,, before any payments were made the employer had the opportunity and the responsibility to report any information which could disqualify the claimant. SOCIAL BENEFIT PAID FOR SECURITY YEAR END CLAIM RANSACTION WEEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING ACO CHARGED THIS IS NOT A BILL OR A REQUEST FOR MONEY DUE TO THIS DEPARTMENT. It is a statement of benefit charges made to your account during the "reporting" month. At the end of the "posting" month, you will receive a Reimbursable Bill (Form 1067) for these charges and any previous liability still outstanding. NEW CHARGES FOR THE REPORTING MONTH 10/08 V GRANT 07/04/09 REG 10/12/08 10/11/08 84.02 TOTAL NEW CHARGES FOR THE REPORTING MONTH 10/08 5,433.0 TOTAL AMOUNT OF NET CHARGES 5,433.02 CONTINUE ON NEXT PAGE 3 -,7 (SO 0 -'AJ S An in the ACO column denotes a charge resulting from an acquisition of another business. �GQ t Prescribed State Board of Accounts City Form No. 201 (Rev. 1995) T ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or 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 s Yl a. ,u !i( lJdI Purchase Order No. ,/"I 1 2 /U 11 Terms -f La_k) eG pd `7 4�ow Y v� Date Due z Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3 O &J Total 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. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. y ALLOWED 20 IN SUM OF ja ON ACCOUNT OF APPROPRIATION FOR Board Members POP or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 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 i/ o?! 20 0ly i n r .Ul� Cost distribution ledger classification if Title claim paid motor vehicle highway fund The following items apply to your benefit ACCOUNT NUMBER: 133438 charges postod ino&WGUST of 2008 ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL LIABILITY FOR THE PERIOD PREVIOUS BALANCE 175.31 1.75 17.53 PAYMENTS 175.31CR .00 .00 -ADJUSTMENT OF INTEREST PENALTY 1.75CR 17.53CR ENDING BALANCE .00 .00 .00 .00 The following items apply to your benefit ACCOUNT NUMBER: 133438 charges posted in SEPTEMBER of 2008 ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL LIABILITY FOR THE PERIOD PREVIOUS BALANCE 1 .00 .00 PAYMENTS 1 890.000R .00 .00 ENDING BALANCE .00 1 .00 i .00 .00 THE TOTAL LIABILITY BALANCE IS LOCATED ON THE LAST PAGE OF THIS BI1,L. 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 the payment due date. If the liability is not paid in full, the Director may file with the clerk of the 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 -6499 or (317) 232 -7395 and ask for Collections. The following items apply to your benefit charges posted in OCTOBER of 2008 ACCOUNT NUMBER: 133438 ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL LIABILITY FOR THE PERIOD PREVIOUS BALANCE .00 .00 .00 -ASSESSMENT OF BENEFIT CHARGES 5,132.12 PAYMENTS 19.28CR .00 .00 ENDING BALANCE 5,112.84 .00 .00 5 THIS IS YOUR TOTAL LIABILITY. PAYMENTS MAILED AFTER THE 20TH OF THE MONTH MAY NOT BE REFLECTED ON THIS BILL. PLEASE $5,112.84 PAY THIS AMOUNT NO LATER THAN.......... NOVEMBER 30, 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 charges 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 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 -6499 or (317) 232 -7395 and ask for Collections. 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee b 0 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) uju M .n Total q3 Qj 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. ALLOWED 20 IN SUM OF I .q5 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoic or b o 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 20 Signatur Cost distribution ledger classification if Title claim paid motor vehicle highway fund 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 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1116!08 133438 Benefit charges Oct'08 -Parks 2,016.00 PAY ALL OUT OF 101, per Michael 11/20/08 Total 2,016.00 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 2,016.00 ON ACCOUNT OF APPROPRIATION FOR 101- General Fund PO# or INVOICE NO. ACCT 1 AMOUNT Board Members Dept TITLE 1125 133438 4110000 2,016.00 1 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 17 -Nov 2008 P&/ Vmmn� Signature 2,016.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund