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HomeMy WebLinkAbout173984 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 00352820 Page 1 of 1 ONE CIVIC SQUARE LONNIE PATTON CHECK AMOUNT: $155.00 CARMEL, INDIANA 46032 CARMEL UTILITIES CARMEL UTILITIES CHECK NUMBER: 173984 CHECK DATE: 6/24/2009 DEPARTMENT ACCOUNT PO NUMBER IN VOICE N UMBER AMOUNT DESCRIPTION 651 5023990 060409 155.00 OTHER EXPENSES 1 l �Y Z CITY OF CARMEL Expense Report (required for all travel expenses) A14 N 2008 mileage reimbursement rate is 58.5 cents /mile EMPLOYEE NAME: LONNIE PATTON DEPARTURE DATE: NA TIME: DEPARTMENT: Utilities /Sewer RETURN DATE: TIME: REASON FOR TRAVEL: LABORATORY PROCEDURES FOR PLANT CONTROL CLASS DESTINATION CITY: EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT X_ TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Parkin Lodging Misc. Total Air -fare Car Rental Other 9 Breakfast Lunch Dinner Snacks Per Diem 6/4/09 CLASS REGISTRATION FEE $155.00 $155.00 $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 Totall $0.001 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $155.00 o 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: rr City of Carmel Form ER06 Revision Date 6/12/2009 Page 1 To ensure proper credit, the q, WASTEWATER OPERATOR/APPRENTICE CONTINUING wastewater approval number V_. EDUCATION CREDIT REPORT MUST be provided: State Form 51139 (R3 4-08) Training Course Approval Number: INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT WWT09- 5945- T06 -G00 Technical CEHours Earned: Operator OApprentice General Contact arned: w: MST In accordan ce with 327 IAC 5- 22- 17(c), the training provider must submit this form within ninety (90) days of the conclusion of the wastewater treatment continuing education course. Mail the completed form to: Wastewater Continuing Education Coordinator Indiana Dept. of Environmental Management 100 N. Senate Ave Mail Code 65-42 Indianapolis, IN 46204 -2251 Incomplete forms will be returned to the training course provider for completion and resubmittal to IDEM. Partial course credit shall not be given to instructors, speakers, or students participating in less than a complete wastewater treatment continuing education course. The training provider must retain a copy of this form for their records for a three (3) year period following the presentation of each wastewater treatment continuing education course. Training providers are encouraged to provide a copy of the completed and signed credit reporting form to the certified operator /apprentice attending the entire wastewater operator continuing education course. g CERTI ED O'E ATOt iAPP E +ITICiEa1 iVlt ►TIiJ �_a_ 1. NAME: 2. ADDRESS (number and street): 'ity: State: ZIP code: ITelephone number. y p p Work: 9 ,317 M ��C(l>? t JJ 'otj1111 Hom Cell: M Check here if this is an address change [3 E -mail Address: MONONA �ouRSErI�oRnnAoaa n.y 3. NAME OF TRAINING COURSE: Laboratory Procedures for Plant Control 4. NAME OF TRAINING COURSE PRO A IDER: Environment, In c. NAME OF IDRGGAe IZATION SPONSORING COURSE: ppro 6. DATE(S) ATTENDED (month, da ear 7. LOCATION June �,00� Indianapolis, Indiana 8. TOTAL NUMBER OF CONTACT HOURS ATTENDED BY CERTIFIED OPERATOR/APPRENTICE AND VERIFIED BY INSTRUCTOR AND TRAINING COURSE PROVIDER: Technical Contact Hours: General Contact Hours: 6.0 0 9. CERTIFICATE OF COMPLETION IS REQUIRED FOR ALL ON -LINE COURSES. I, the undersigned, certify under penalty of law that this document (and any attachments) were prepared under my direction or supervision and that the information submitted is, to the best of my knowledge and belief, true, accurate, and correct. I also understand that any omissions or misrepresentation may result in the denial of continuing education credit for this course. 10..SIGNAT!JRE OF INST RUCTOR: 11. PRINTED NAME OF INSTRUCTOR: Ann Bersbach 12. SI N RE OF CERTIFIED OPERATORIAPPRENTICE: 13. PRINTED NAME OF CERTIFIED OPERATORIAPPRENTICE: 14. CO TINUING EDUCATION CREDIT HOURS ARE TO BE APPLIED TO: `perator certification /apprentice number: Class: Expiration date: Operator certification /apprentice number: Class: Expiration date: National City Online Banking Page 1 of 1 Online Banking CLOSE WINDOW Check Detail Account Number: ...3693 Check Number: 904 Check Paid Date: 6/4/2009 Amount: $155.00 View Front Only Zoom In '.00m of Print LONNIE, J— PATTON Dear 904 TIFFANY N P A ftC1N. -088T9i460 139(N 6TH ST PH.:76Y MIDDLEW U4, 4MW,i48$ i7�u7EROF gip,, doQ7 C� D© 5i: E�9B fig t93i� �4 'C1 DOD 1 55DD 6.. s 7 1 02009 The PNC Financial Services Group, Inc. All Rights Reserved. National City Bank. Member FDIC. This site is subject to and protected by copyright and trademark laws of the United States and international law. Review National City's privacy notice and terms and conditions for Online Banking. Online Banking Zero Liability Pledge. 1!21 Equal Housing Lender Version: 15.7.6.0 [951 https:// onlinebanking .nationalcity.com /OLB/ secure /CheckDetail .aspx ?AE= e8LXcDIIOQd... 6/12/2009 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 6/15/2009 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 6/15/2009 060409 $155.00 hereby certify that the attached invoice(s), or bill(s) is (are) true and orrect and I have audited same in accordance with IC 5- 11- 10 -1.6 Date ffi elf VOUCHER 095814 WARRANT ALLOWED h960 IN SUM OF PATTON, LONNIE WASTEWATER Carmel Wastewater Utility N ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 060409 01- 7042 -06 $155.00 Voucher Total $155.00 Cost distribution ledger classification if claim paid under vehicle highway fund