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Home My WebLink About180118 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 129401 Page 1 of 1 j ONE CIVIC SQUARE MICHAEL HOLLIBAUGH CARMEL, INDIANA 46032 CARMEL IN 46032 CHECK AMOUNT: 18011 7 CHECK NUMBER: 180118 <ION 00 CHECK DATE: 12/8/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4351100 240.00 CAR CLEANING 1192 4355300 105.57 ORGANIZATION MEMBER v Midwest Academy 801 Congressional Blvd Carmel, IN 46032 ADEMY" t DwEST 397- 8439500 4 Office C 317- 843 -2833 Fax www,midwestacademyofindiana.org Donor Information: Ite_m,# Name: tC �c�. C. i I Y:�{.�tGyt'� 1 W) Address: City, State, Zip: C �^•lfV'r by Phone: "J�J�� w: Online Llcensing This page serves as your receipt for this transaction. Your payment will appear on your credit card statement as "HEALTH /PROF LIC BUREAU To maintain this page for your records, you may print this page by clicking the "Print Receipt" button below. What to do next? Renewal Check back on the MyLicense site in 24 48 hours to see if your expiration date was extended. If not, this may mean there is a problem with your renewal application and you will be contacted. e If you answered "Yes" to any of the disciplinary questions, you must provide additional information before your renewal can be processed. You may still work with your current license for up to 90 days while your renewal is being reviewed by the board. When your license was issued or last renewed, you received a permanent license card one will not be generated from this renewal (except for CSR). Duplicate or replacement license cards can be purchased by returning to the licensing home page. Payment received thank you. Licensee: Michael P. Hollibaugh License Number: LA29300015 Authorization Code: 27633A Received Date: 12/1/2009 1:45:16 PM Transaction ID: 4997873 Credit Card Number: XXXX XXXX XXXX 0014 Fee Amount: $100.00 Enhanced Fee: $2.50 Instant Fee: $3.07 Total Payment: $105.57 Renew Another License Louout Indiana Professional Licensing Agency We work to Architects Landscape Architects Board keep you working 402 W. Washington St. Room W072 Indianapolis, IN 46204 r[P L A Professional Licensing Agency Michael P. Hollibaugh City of Carmel DOCD 1 Civic Square Carmel IN 46032 Renewal Information Notice License LA29300015 Expire Date /Status: 12/01/2009 Active Web Login ID: LA29300015 Web Password: Social Security Number without Dashes Your Landscape Architect license will soon be expiring. Your renewal can now be processed online. Online renewal is faster and more accurate. Renew online 24 hours a day, 7 days a week. It only takes a few minutes and is QUICK EASY. By using the online renewal, your renewed license is posted within one business day. Renew at www.pla.in.gov and select the License Express link. Your Login information is above. You can use your Discover, Mastercard, or Visa credit card or debit card. You may update your address, email, phone numbers during the online renewal process. The fee to renew your Landscape Architect license is $105.57. This includes the $100 renewal fee and credit card processing fees. If you have questions about the renewal, contact the Board of Registration for Architects and Landscape Architects by email at Pla10(@pla.in.gov Pocket Cards The Indiana Professional Licensing Agency no longer issues pocket license cards at license renewal. If you need to purchase a new pocket card, you may do so online at www.pla.in.gov select the License Express link from the PLA home page (pocket cards can only be purchased online). Please note that permanent pocket license cards no longer contain expiration dates, although a card with an expiration date is also available for purchase online. Late Fees if you apply for renewal of your license after December 1, 2009, you will be assessed a $50.00 late fee for each expired renewal, in addition to the standard renewal fees. There are no exceptions if you renew late, you must pay the late renewal fee in order to renew your expired license. IMPORTANT ADDITIONAL INFORMATION REGARDING YOUR PROFESSION: THIS IS A NOTIFICATION ONLY AND NOT AN OFFICIAL RENEWAL FORM. DO NOT SEND A CHECK OR MONEY ORDER WITH THIS FORM or BY ITSELF. 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)) 12/01/09 4997873 Landscape Architect License $105.57 12/04/09 Mike's Car Wash Certificates $240.00 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 N WARRANT NO. ALLOWED 20 Michael Hollibaugh IN SUM OF c/o One Civic Square Carmel, IN 46032 $345.57 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1192 4997873 43- 553.00 $105.57 1 hereby certify that the attached invoice(s), or 1192 43- 511.00 $240.00 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 Monday, Decemberr67, 2009 [Vector, D S Title Cost distribution ledger classification if claim paid motor vehicle highway fund