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164323 09/30/2008 a CITY OF CARMEL, INDIANA VENDOR: 00352754 Page 1 of 1 ONE CIVIC SQUARE TED LENZE CHECK AMOUNT: $326.55 CARMEL, INDIANA 46032 5575 BUTTONWOOD DRIVE NOBLESVILLE IN 46060 CHECK NUMBER: 164323 CHECK DATE: 9/30/2008 DEPARTMENT ACCOUNT PO NUMBER INVOIC NU AMOUNT DESCRIPTION 1120 4128000, 326.55 TUITION REIMBURSEMENT w Jb /b5 /LbbJ 13: Lb 31/5/14144 CARMEN FIRE DEPARTMT PAGE 01 City Of Cannel Tuition Reimbursement ,A,pplication Form Part I (to be completed by employee) (Please print. Subunit completed fonm to Department Head rip or to commencement of course.) Employee Name `T Le 2 Department E�12 it SSN lire Date 41' Educational Institution* —T V Y TrL �t Nam of Course" PO L. 16 Starting Date of Course (month/day /year) V y to 6 q By sigming below, I sign4 that I understand the following: The tuition reimbursement program is subject to the terms of Carmel City Code, Section. 2 -59. o To receive reimbursement for tuition, I must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit the book list for the course and an original itemized receipt for all books purchased. If I leave City of Carmel employment sooner than one (1) year after the end of this course, I will repay the City in full for its tuition and book reimbursements for this course. The tax status of =benVi ect to ed eral law, which, may change from time to time. Employee Signature Date /2 /b 9' Part H (to be completed by Department Head) (Submit to Humau Resources) By signing below, I certify that the applicant will havc born omployed full -time by the City for at least one (1) Year prior to the commencement of the course, and has not been subject to a disciplinary probation., suspension or demotion within 90 days prior to the beginning oJAe course. The final claim will be paid from my department's budget, subject to the terms Secti 5 o Carmel City Code. Department Head Signature Dam ]Part III (to be completed by Director of Human Resources) Final Approval a— Date If denied, reason for denial The tuition reimbursement program covers only full -wme ftr CA mes. offered through a deputing bs dtution ancredibad by the North Central Association of Colleges and Schools or an eguivalent rcgiowl accreditor. An application will not be considered a mplete unless a course description from the school's literature is attached_ COLLEGEWIDE COURSE OUTLINE OF RECORD POL 101, INTRODUCTION TO AMERICAN GOVERNMENT AND POLITICS APO 111 /POLS 111, AMERICAN NATIONAL GOVERNMENT COURSE TITLE: Introduction to American Government and Politics /American National Government COURSE NUMBER: POL 101 /APO 111 PREREQUISITES: Demonstrated competency through appropriate assessment or or earning a grade of "C" or better in ENG 025 Introduction to College Writing II and ENG 032 Reading Strategies for College II DIVISION: General Education PROGRAM: General Education CREDIT HOURS: 3 CONTACT HOURS: Lecture: 3 DATE OF LAST REVISION: Spring, 2004 EFFECTIVE DATE OF THIS REVISION: Fall, 2004 CATALOG DESCRIPTION: Studies federalism, theories of the origins and purposes of government and other aspects of the American government including interest groups, political parties, and the electoral process. Emphasis is placed on constitutional backgrounds and the organization and functions of the executive, legislative, and judicial segments of the national government, civil liberties and civil rights, public opinion, media, bureaucracies, and domestic and foreign policy. MAJOR COURSE LEARNING OBJECTIVES: Upon successful completion of this course the student will be expected to: 1. Describe and discuss the foundations and bases of American government and democracy including the Constitution, Bill of Rights, and Federalism. 2. Describe the various aspects of political behavior of individuals and groups including political parties, public opinion, interest groups, media, nominations, campaigns, and elections. 3. Describe the operations of the various governmental institutions including executive, legislative, judicial, and administrative functions. 4. Evaluate recent global developments and their impact on public policy in the areas of domestic and foreign affairs. COURSE CONTENT: Topical areas of study include History and theories of government Rise of American democracy Constitutional structure Public Policy Challenges of Federalism media civil rights globalism civil liberties current events case law Ivy Tech State College 1 POL 101 Planning and Education ACADEMIC HONESTY STATEMENT: The College is committed to academic integrity in all its practices. The faculty value intellectual integrity and a high standard of academic conduct. Activities that violate academic integrity undermine the quality and diminish the value of educational achievement. Cheating on papers, tests or other academic works is a violation of College rules. No student shall engage in behavior that, in the judgment of the instructor of the class, may be construed as cheating. This may include, but is not limited to, plagiarism or other forms of academic dishonesty such as the acquisition without permission of tests or other academic materials and /or distribution of these materials and other academic work. This includes students who aid and abet as well as those who attempt such behavior. ADA STATEMENT: Ivy Tech State College seeks to provide reasonable accommodations for qualified individuals with documented disabilities. If you need an accommodation because of a documented disability, please contact the Office of Disability Support Services. If you will require assistance during an emergency evacuation, notify your instructor immediately. Look for evacuation procedures posted in your classroom. Ivy Tech State College 2 POL 101 Planning and Education Account Summary Page 1 of 1 SITE MAP Account Summary To make a payment by credit card. select Credit Card Payment. Lenze, Theodore A 2008 SUMMER To choose another Term, choose Select Term from either the Term navigation bar or in the SITE MAP, Due Date: Previous Balance: 0.00 Amount Due Through Selected Term: 0.00 Account Balance Through Selected Term: 0.00 Total Account Balance: 0.00 A minus sign to the right of this amount indicates an amount we owe you Credit Card Payment Current Term 2008 SUMMER Effective Date Subcode Description Charges Credits 05 -08 -08 15588 ll Summer tuition in -state 285.00 0 05 -08 -08 25534 INTERNET -BASED DE FEE -11 30.00 0 05 -08 -08 27000 H1 Technology Fee 40.00 0 05 -08 -08 97010 VISA/MC PAYMENT 0 355.00 Back to to Any problems or comments call the SOS Helpdesk at 1- 8774VY -TECH or report the probl online Admi ssions off ice I Bursars Of fice I Registrar's Off ice I Financial Aid Office I Disability Support_Serv_ices I Career Services RELEASE: 1.20> https:// web4.ivytech.edu/ia- bin/tsrvweb 9/19/2008 Grades Page 1 of 1 SITE MAP Grades Lenze, Theodore A 2008 SUMMER To choose another Term, choose Select Term from either the Term navigation bar or in the SITE MAP. The deadline for instructors to post final semester grades online for the following semesters are: Spring 2008 Friday, May 16, 2008 Summer 2008 Friday, August 9, 2008 Attempted Earned Quality Quality Section Course Title Grade Hours Hours Hours Points GPA POL 101 -121 INTRO AMERICAN GOV POL A 3.00 100 3.00 12.00 Current Term 3,00 3,00 12.00 4.000 Cumulative through 2008 SUMMER 51.00 33.00 123.00 3.727 Instructions for obtainin official trans Back to t op Any problems or comments call the SOS Helpdesk at 1- 877 IVY -TECH or repo the pr oblem online. Admissions Office I Bursars Office I Re Office I Finan Aid Office I Disability Sup port Services I Career Services RELEASE: 1,207 https:// web4.ivytech.edu /ia- bin/tsrvweb 9/19/2008 Account Summary Page 1 of 1 SITE MAP Account Summary TIM To make a payment by credit card, select Credit Card Payment. Lenze, Theodore A 2008 SUMMER To choose another Term, choose Select Term from either the Term navigation bar or in the SITE MAP. Due Date: Previous Balance: 0.00 Amount Due Through Selected Term: 0.00 Account Balance Through Selected Term: 0.00 Total Account Balance: 0.00 A minus sign to the right of this amount indicates an amount we owe you Credit Card Payment Current Term 2008 SUMMER Effective Date Subcode Description Charges Credits 05 -08 -08 15588 11 Summer tuition in -state 285.00 0 05 -08 -08 25534 INTERNET -BASED DE FEE -11 30.00 0 05 -08 -08 27000 H1 Technology Fee 40.00 0 05 -08 -08 97010 VISA/MC PAYMENT 0 '355.00 Back to top Any problems or comments call the SOS Helpdesk at 1- 877 IVY -TECH or r eport the rob online. Admissions Office I Bursars Office I Regi Office I Financial A id Offic I Disability_ Suppo Services I Career Services RELEASE: 1.20> https: /web4.ivytech.edu/ia- bin/tsrvweb 9/19/2008 Grades Page 1 of 1 SITE MAP Grades WIM Lenze, Theodore A 2008 SUMMER To choose another Term, choose Select Term from either the Term navigation bar or in the SITE MAP. The deadline for instructors to post final semester grades online for the following semesters are: Spring 2008 Friday, May 16, 2008 Summer 2008 Friday, August 9, 2008 Attempted Earned Quality Quality Section Course Title Grade Hours Hours Hours Points GPA POL 101 -121 INTRO AMERICAN GOV POL A 3.00 3.00 3.00 12.00 Current Term 3.00 3.00 12.00 4.000 Cumulative through 2008 SUMMER 51.00 33.00 123.00 3.727 Instructions for obtaining your official transcript Back to too Any problems or comments call the SOS Helpdesk at 1. 877 IVY -TECH or repo the problem online. Admissions Office I Bursars Office I Registrar's Office I Financial Aid Office I Disabilit Support Services I Career Services RELEASE: 1.20> NBC149 Specialty Books, 5 North Court St NBC149 Athens, OH, 45701 Specialty Books 5 North Court St United States Athens OH 45701 aboyd @specialtybookstore.com United States To: Theodore Lenze 5801 CORRALBERRY CT CARMEL, IN 46033 -9598 UNITED STATES II�II III�II�IIII�II I�I �II Marketplace: Amazon Order Number: 1020190 Ship Method: Standard Customer Name: Theodore Lenze Order Date: 6/3/2008 Marketplace Order 058- 2653012- 6408312 Email: ted @tedlenze.com Items: Qty Item Locator Condition Price 1 Living Democracy, Brie... Books Daniel M. Shea, Joanne Connor Green, Christopher E. Smith Good $37.56 S K U 10850046 ISBN: 0136132146 Subtotal: $37.56 Shipping: $3.99 Total: $41.55 Notes: Thanks for your order! If you have any questions or concerns regarding this order, please contact us at aboyd @specialtybookstore.com CHASE i I Want ro purchase optional Chase Payment Protector I Please write amount enclosed. Plan. I've read the Benefits New address or e-mail? Print on back. Disclosures on back of insert. Fn s mate 84637 SEX Z 17808 D JENNIFER M LENZE 5801 CORRALBERRY CT Y CARMEL IN 46033 -9598 CARDMEMBER SERVICE PO BOX 94014 PALATINE IL 60094 -4014 05/08 8548396812829091267f730 IVY TECH FT BEN INOPLS IN 06103 55432 868155000 355.00 3086 AMZ'A on P aYme nts AMZN COf vVBILL WA 41.55 a VOUCHER NO. WARRANT NO. ALLOWED 20 Ted Lenze IN SUM OF $326.55 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 41- 280.00 $326.55 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 Title Cost distribution ledger classification if claim paid motor 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Tuition $326.55 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