174241 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 354963 Page 1 of 1
ONE CIVIC SQUARE PETER BRENNAN, JR.
CARMEL, INDIANA 46032 2414 S MARKET STREET CHECK AMOUNT: $90.00
YORKTOWN IN 47396 CHECK NUMBER: 174241
CHECK DATE: 718/2009
DEP ARTME NT AC COUNT PO N UMBER INVOI NUM AMOUNT DESCRIPTION
651 5023990 90.00 OTHER EXPENSES
1 CITY OF CARMEL Expense Report (required for all travel expenses)
2008 mileage reimbursement rate is 58.5 cents /mile
EMPLOYEE NAME: PETER BRENNAN DEPARTURE DATE: NA TIME:
DEPARTMENT: Utilities /Sewer RETURN DATE: TIME:
REASON FOR TRAVEL:ONLINE COURSES 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 Other I Parking Breakfast I Lunch Dinner Snacks Per Diem
CLASS REGISTRATION FEE PRIMARY TREATMENT
672 CLASS REGISTRATION FEE PRIMARY TREATMENT 3 0 30.00
6/29/09 CLASS REGISTRATION FEE PRIMARY TREATMENT $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
Total $0.00 $0.001 $0.00 $0.0
0.00 $0.001 $0.00L $0.00 10.001 $0.00 $90.00
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 7/1/2009 Page 1
Approved Environment, Inc.
P.O. Box 42744
Indianapolis, IN 46242
Phone: 1- 877 -241 -9858
www.approvedce.com
.Tune 29, 2009
Receipt
Peter R Brennan JR
2414 S Market ST
Yorktown, IN 47396
317 -432 -0329
stacyandpete@att.net
Item Item Name Quantity Unit Price Amount
I Online Courser 2 $30.00 $60.00
Primary Treatment
TOTAL $60.00
Paid By: CC xxxx xxxx -xxxx -1749 Exp. 03/10 Confirmation #150247
Thank you,
Approved Environment, Inc.
P.O. Box 42744
Indianapolis, IN 46242
www.qpprovedce.com
Approved Environment, Inc.
P.O. Box 42744
Indianapolis, IN 46242
Phone: 1- 877 -241 -9858
www.approvedce.com
June 23, 2009
Receipt
Peter R Brennan JR
2414 S Market ST
Yorktown, IN 47396
317- 432 -0329
stacyandpete@,att.net
Item Item Name Quantity Unit Price Amount
I Online Course: 1 $30.00 $30.00
Primary Treatment
TOTAL $30.00
Paid By: CC xxxx xxxx -xxxx- 0522 Exp. 01/11 Confirmation #009638
Thank you,
Approved Environment, Inc.
P.O. Box 42744
Indianapolis, IN 46242
www.approvedee.com
Certificate of Completion Approved Environment, Inc. Page 1 of 1
Approved Environment, Inc.
P.O. Box 47895
Indianapolis, IN 46247 -0895
1- 877 241 -9858
Email: info {a 1,approvedee.com
Certificate of Completion
Courses are approved in the following states: Indiana, Illinois, Ohio, Alabama, Delaware. South
Carolina, North Carolina, Maryland, Kentucky and Ontario, Canada,
Name: Peter R Brennan
Address: 9609 HazelDell Parkway, Indianapolis, IN 46280
Course Title: Wastewater Preliminary Treatment
Course Value: I Contact Hour
Approval Number: YN WWT09 -5904 TOl -G00, OH OEPA- 5296782 -OM, NC
CEO 1140415, MD 3463 -05 -06
Date: 6/29/09
Approximate Time Spent Taking the Course: 60 minutes.
Operator Certification License Number: WWO17025
Operator Class Level: II
License Expiration. Date: 06/3
Operator Signature: Y,
Training Provider Signature:
Ann Bersbach, Approved Environment, Inc.
Copyright 2002, Approved Environment, Inc., Indianapolis, Indiana
http:// www. approvedce. com/ onlineCEUs /ceuCertificateOfCompletion.asp 6/29/2009
"'�q, WASTEWATER OPERATOR /APPRENTICE CONTINUING To ensure proper credit, the
�l �q wastewater approval number
EDUCATION CREDIT REPORT
MUST be provided.
State Form 51139 (R314 -08) Training Course Approval Number:
INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Td9',59J 61 f,*D�
1816 U VV
Operator CApprentice Technical 1 HOUR ours Earned:
General Contact Hours Earned:
0
Y IIS °T;RUGTC3NS': m�
In accordance 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 attendin the entire wastewater operator continuing education course.
CE, RT1E13( P- RigTOFtI'PPI1= [IG�IMF(7�RMAfION
1. NAME:
F e 4- e r Bremt'
2. ADDRESS (number and street):
City: State: (T i K ZIP code: Telephone number:
ar �+SL3 73 (o Ho
om e l 3 1 7 7 1 -f- 37
He /Cel:� q,3.) 03
Check here If this is an address change 0 E -mail Address:
3. NAME OF TRAINING COURSE: s +e w `04e r- F I M 1 Q
4. NAME OF TRAINING COURSE PROVIDER: i! 5. NAME OF OR ANIZATION SPONSORING COURSE:
APPROVED ENVIRONMENT INC SAME
6. DATE(S) ATTENDED (month, day, year): /f q Q 7. LOCATION ATTENDED:
VWVW.APPROVEDCE.COIVI
8. TOTAL NUMBER OF CONTACT HOURS ATTENDED BY CERTIFIED OPERATORIAPPRENTICE AND VERIFIED BY INSTRUCTOR AND
TRAINING COURSE PROVIDER:
Technica! Contact Hours: G Hours:
1 HOUR 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. SIGNATURE OF INSTRUCTOR: 11. PRINTED NAME OF INSTRUCTOR:
Ann Bersbach
12. SIG URE C OPERATORIAPPRENTICE: 13. PRINTED NAME OF CERTIFIED OPERATORIAPPRENTICE:
14, CONTINUING EDUC TION CREDIT HOURS ARE TO BE APPLIED TO:
Operator certification /apprentice number: Class: Expiration date:
W�,J d 17d 5 db -30- C)�
Operator certificati onlap pre ntice number: Class: Expiration date:
Certificate of Completion Approved Environment, Inc. Page 1 of 1
Approved Environment, Inc.
P.O. Box 47895
Indianapolis, IN 46247 -0895
1- 877 241 -9858
Email: info(a)approvedee.coin
Certificate of Completion
Courses are approved in the following states: Indiana, Illinois, Ohio, Alabama, Delaware, South
Carolina, North Carolina, Maryland, Kentucky and Ontario, Canada.
Name: Peter R Brennan
Address: 2414 S Market ST, Yorktown, IN 47396
Course Title: Primary Treatment
Course Value: 1 Contact Hour
Approval Number: IN WWT09 -5905 T01-GOO,, OH OEPA- 5296785 -OM, NC
CEO 1140414, MD 3464 -05 -06
Date: 6/29/09
Approximate Time Spent Taking the Course: 60 minutes.
Operator Certification License Number: WWO17025
Operator Class Level: II
License Expiration Date: 06/30/2009
Operator Signature: S L R 2 W J�� t L
Training Provider Signature:
Ann Bersbach, Approved Environment, Inc.
Copyright 2002, Approved Environment, Inc., Indianapolis, Indiana
http:// www. approvedce. com/ onlineCEUs /ceuCertificateOfCompletion.asp 6/29/2009
s.A To ensure p roper credit, the
Qom° wa WASTEWATER OPERATOR/APPRENTICE CONTINUING p p
o�� g wastewater approval number
EDUCATION CREDIT REPORT MUST be provided.
State Form 51139 (R3 4 -l)8) Training Course A j pprova T l Number:
c'� INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Tt1 q /65 ld1 C70
Operator ❑Apprentice Technical �oHOUR ours Earned
General Contact Hours Earned:
0
In accordance 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/aRprentice attending the entire wastewater operator continuing education course.
u CER7I;,�I,ER�O�t��. �T�: Q_ IICIAFP,�t�1TaC�EIN.EORMAT[,��N �P°
r
1. NAME:
2. ADDRESS (number and street): ;2
City: State: a t J ZIP code: Telephone
C Telephone number:
c /73 1 Work: p7 31 7"` 7
Home /Cell: .0
Check here if this is an address change E -mail Address: S QC Y awl !V
3. NAME OF TRAINING COURSE:
4. NAME OF TRAINING COURSE PROVIDER: 5. NAME OF ORGANIZATION SPONSORING COURSE:
APPROVED ENVIRONMENT INC SAME
6. DATE(S) ATTENDED (month, day, year): Q 7. LOCATION ATTENDED:
(P-0q, o I I/W1NV.APPROVEDCE.COM
B. TOTAL NUMBER OF CONTACT HOURS ATTENDED BY CERTIFIED OPERATORIAPPRENTICE AND VERIFIED BY INSTRUCTOR AND
TRAINING COURSE PROVIDER:
Technical Contact Hours: General Contact Hours:
1 HOUR 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. SIGNATURE OF INSTRUCTOR: 11. PRINTED NAME OF INSTRUCTOR:
5 Ann Bersbach
12. SIGNATU F CERTIFIFID OPERATORIAPPRENTICE: 13. PRINTED NAME OF CERTIFIED OPERATORIAPPRENTICE:
rN
14. CONTINUING EDUCATION C EDIT HOURS ARE TO BE APPLIED TO:
Operator certification /apprentice number: Class: Expiration date:
\N W 0 74 ate 30
Operator certification /apprentice number: Class: Expiration date:
Certificate of Completion Approved Environment, Inc. Page 1 of 1
Approved. Environment, Inc.
P.O..Box 47895
Indianapolis, IN 46247 -0895
1- 877 241 -9858
Email: inNa approvedce.com
Certificate of Completion
Courses are approved in the following states: Indiana, Illinois, Ohio, Alabama, Delaware, South
Carolina, North Carolina, Maryland, Kentucky and Ontario, Canaria.
Name: Peter R Brennan
Address: 9609 HazelDell Parkway, Indianapolis, IN 46280
Course Title: Final Effluent I
Course Value: I Contact Hour
Approval Number: IN WWT09- 5913- TOI -G00, OH OEPA- 5296736 -OM, NC
CE01140408, MD 3472 -05 -06
Date: 6/29/09
Approximate Time Spent Taking the Course: 60 minutes.
Operator Certification License Number: WWO17025
Operator Class Level: II
License Expiration Date: 06/30/2009
Operator Signature:
Training Provider Signature
Ann Bersbach, Approved Environment, Inc.
Copyright 2002, Approved Environment, Inc., Indianapolis, Indiana
http:// www. approvedce. com/ onlineCEUs /ceuCertificateOfCompletion.asp 6/29/2009
To ensure proper credit, the
WASTEWATER OPERATORIAPPRENTICE CONTINUING wastewater approval number
EDUCATION CREDIT REPORT
MUST be provided.
State Form 51139 (R3 14 -08) Training Course Approval Number:
INDIANA DEPARTMENT Or ENVIRONMENTAL MANAGEMENT r 3 1--&60
18i6
Operator ❑ApprentlCe Technical Contact Hours Earned:
1 HOUR
General Contact Hours Earned:
0
T)C3NS. a
i
In accordance 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 ]DEM.
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 attendin the entire wastewater operator continuing education course.
jeW jAWV �C RTI„ D 4PER&TQ �pR 1 ICE 4NFORNI �14N
1. NAME: E er R B r-0 N
2. ADDRESS (number and street): ;,2Y 1 V S y f ^PwI 6� S+—
City: State: ZIP code: Telephone number:
Sid; n 47 3� work: a 5 71(
�'6rk-!0 W l HomelCell: spy
g317-q32
Check here If this is an address change E -mail Address: S ao- Qpd E La hi f=
1 CORSINFORIVIA�'IOhI
3. NAME OF TRAINING COURSE:
P tzoJ GFF1ue;�
4. NAME OF TRAINING COURSE PROVIDER: 5. NAME OF ORGANIZATION SPONSORING COURSE:
APPROVED ENVIRONMENT INC SAME
6. DATE(S) ATTENDED (month, day, year): (oe a 4 q D 7. LOCATION ATTENDED:
1 1 VWVW.APPROVEDCE.COM
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:
1 HOUR 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. SIGNATURE OF INSTRUCTOR: 11. PRINTED NAME OF INSTRUCTOR:
Ann Bersbach
12. SIGNAqE OF CERTI D OPERATOR/APPRENTICE: 13. PRINTED NAME OF CERTIFIED OPERATORIAPPRENTICE:
I-e r 7 et4tz& P3
14. CONTINUING EDUCATION CREDIT HOURS ARE TO BE APPLIED TO:
Operator certificationlapprentice number: Class: Expiration date:
v.)1,� 0) 70 5 No- 30 -;200�
Operator certificationlapprentice number: Class: Expiration date:
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) r
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
T1042
BRENNAN, PETER Purchase Order No.
WASTEWATER PLANT Terms
Due Date 7/1/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/1/2009 062909 $90.00
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
/e/
Date l i a
VOUCHER 095957 WARRANT ALLOWED
T"I042 IN SUM OF
BREIVNAN, PETER
WASTEWATER PLANT
Carrel Wastewater Utility
�N ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
062909 01- 7042 -06 $90.00
Voucher Total $90.00
Cost distribution ledger classification if
claim paid under vehicle highway fund