174933 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 361534 Page 1 of 1
0 ONE CIVIC SQUARE INDEPENDENT ELECTRICAL CONTRAC�WK AMOUNT: $1,380.00
CARMEL, INDIANA 46032 2131 N SHERMAN DRIVE
`o INDIANAPOLIS IN 46218 CHECK NUMBER: 174933
CHECK DATE: 7/22/2009
DEPA ACCOUNT PO NUMBER INV OICE NUM BER AMOUNT DESCRIPTION
601 5023990 W08832 72009 1,380.00 TRAINING
Cen tral Ind IEC
Electrical Apprenticeship Registration Forma
pp p 9
2009 -2010
!REGISTRATION DEAI)IIN� y iil X 31 2Q09
Fill out this form fora` New Returrurig'or Trans �rentices
(Regis rec this date cannot beguaranteed placement auto =the program)
�I)eposit of 25% as due with regastration�'� �3alance MUST be p din full Eby Sept 30 c t
*failure to;pay ay 9 /30/09 wil res ult an °termin of app frorra program:
Name: i D 1 �1 LL a SS 32 1 7,Y rJ %Ord
Home Address: /3 71 L O/l6 Z
City: -b/�a /I State: T:/J County: 1x,10 /1C Zip: 4&
Home Phone: 317� 7 5__? E -mail: a CAA
Emergency Contact: leo &h e e� Relationship: M&I
Company Sponsor (employer): C4
Company Address: 34 50 W /3/ We Fz�" D l x la=k 0 74
Company Phone: /T 28 o Fax: 733- 2v s E -Mail:
Contact Name: o Z &ya,�''�
Please register the above apprentice to begin in the year noted below (check one)
111" Year ❑2 Year ❑2 Year Test Out* E3 rd Year p4 Year
*Credit may be granted for completion of related technical training upon submission of
satisfactory evidence and completion of "test out" material. A passing score of 70% or
better on "test out" material is required to determine the amount of credit received toward
the completion of the related and supplementary instruction. Apprentices may receive
credit for no more than the first year of commercial apprenticeship.
Central Indiana IEC, Inc
2131 N. Sherman Dr, Indpls, IN 46218
Ph: 317 562 -1102 Fax: 317 562 -1593
Website: www.iec -indy orb
E -mail: sherri @iec- indy.org
For Office Use Only: Registration /Forms rec'd _Deposit rec'd Test Date Test Score Class Day
TUITION ��o`
Member Tuition $595.00 er semester (2 per year)
Non Member Tuition $795.00 per semester (2 per year
One Time Enrollment Fee $175.00 (non refundable fee)
Test Out Fee (per year) $150.00 (non refundable fee)
REFUND POLICY
TUITION
100% refund for cancellations prior to August 21 St
75% for cancellations prior to 3 class
50% for cancellations prior to 5` class
25% for cancellations prior to 7 class
No refunds after 8 scheduled class
TEXTBOOKS
100% refund prior to or on August 21, 2009
There will be no refund for books after the start of class.
Test Out and Registration Fees are Non Refundable
TEXTBOOK FEES SUBJECT TO CHANGE
Commercial 1 Year Electrical Wiring Residential 16E $375.00
Usage of Blueprints
NEC 2008 Tabs
GE Lamp Catalog
Student Manual
Calculator
Commercial 2 "d Year Electrical Systems based on NEC 2008 $225.00
Usage of Blueprints
Student Manual
Commercial 3 Year Building Trades Printreading Part 3 $450.00
Usage of Blueprints
Electrical Grounding Bonding 2E
Electrical Motor Controls 4E Workbook
Student Manual
OSHA 10hr First Aid -CPR Cert.
Commercial 4 Year Stallcup's Electrical Design 2008 $190.00
Student Manual
7% Indiana Sales Tax will be added to text and reference books
Additional Reference Books Available from IEC
Ugly's Book 2008 $17.00
NEC 2008 $70.00
(included in 1 st year fees)
NEC 2008 Tabs $17.00
Calculators $15.00
(included in 1S year fees)
Jobsite Safety Handbook 1.50
English Spanish version
De' osit -of 25 %for all fees, I e tuition textbooka,m due with 1091 straton
1 St year apprentices deposit: $286.25 per apprentice
2n year apprentices deposit: $205.00 per apprentice
3 rd year apprentices deposit: $261.25 per apprentice
4 th year apprentices deposit: $196.25 per apprentice
Re Istration;- Checklist all forms must be corgi _leted and received with re ist`ration`
1 St year applicants
Registration Form
❑US Dept of Labor B.A.T. Apprenticeship Agreement
[]Application for Apprenticeship
❑Indemnity Form
❑One of the following:
Birth Certificate
Valid Driver's License
Selective Service or Gov't Issued ID Card
One of the following:
High School Diploma
GED Certificate or Letter of Recommendation from employer
1125% deposit per applicant
[]Schedule Assessment Test Date
2nd 3rd 4 th year returning apprentices
❑Registration form
❑25% deposit per apprentice
Student's Name: Diallo, Amadou TJ Employer: City of Carmel
Instructor: Dave Sloan
Grade Level: 3
Today's Date: 6/9/09
QUIZES Homework OJT Hours
f N3 T 0
tal
`05t� `YTOMours
u T C
o
Dat e W�qOUIZ Name j Da te rnpl6ted
12/31/08 100 100 100.00% 12/31/08 100 95 95.00%' Jun '08 160.00
1/0/00 0 0 0.00%! 1/0/00 0 0 0.00% Jul '08 160.00
1/0/00 0 0 0.00% 1/0/00 0 0 0.00% Au '08 160.001
1/0/00 0 0 0.00% 1/0/00 0 0 0.00% Sept'08 160.00
1/0/001 0 0 0.00% 1/0/00 0 0 0.00% Oct '08 160.00
1/ /00 0 0 0.00% 1/0/00 0 0 0.00% Nov '08 160.00
1/0/00 0 0 0.00% 1/0/00 0 0 0.00% Dec '08 160.00
1/0/00 0 0 0.00%, 1/0/00 0 0 0.00% Jan '09 160.00
1/0/00 0 0 0.00%, 1/0/00 0 0 0.00% Feb '09 160.00
1/0/00 0 0 0.00% 1/0/00 0 0 0.00% Mar '09 1 200.001
1/0/00 0 0 0.00% 1/0/00 0 0 0.00% Apr'09 200.001
1/0/001 0 0 0.00%: 1/0/00 0 0 0.00% May '09 0.00
1/0/00 0 0 0.00% 1/0/00 0 0 0.00% Current YTD Total 1,840.001
1/0/00 0 0 0.00% 1/0/00 0 0 0.00% 3 Prior YTD Total 3,820.0
1/0/00 0 0 0.00 1/0, 0 0 0.00% Accum.-Total 5,660:
1/0/00 0 0 0.00%1 1/0/00 0 0 0.00% uati6Jh<.Requii6ffients,;'=-,.
1/0/00 0 0 0.00%: 1/0/00 0 0 0.00% Total Re 'd Hrs 8,000.00
1/0/00 0 0 0.00% 1/0/00 0 0 0.00% Total Hrs. Short 1 -2.340.00
1/0/001 0 0 0.00% 1/0/00 0 0 0.00%
1 /0 /00 0 0 0.00% 1/0/00 0 0 0
Total Number of Quizes given 1 Total Number of Homework assignments, 1
Total Number of Missed Quizes j 0 Total Number of Missed assignments 0
D
W J
'I S 166 00-XT J�rst Semester ssto&hi A ttendance
§&rriest& OLiiz:Grade otnewon r��
2/5/09 10 10 100.00% 2/5/09 30 30 100.00% YTD Hrs Off ered 156.00
2/5/09 10 10 100.00% 3/19/09 40 40 100 00% ifff!Ars Present 144.00
2/12/09 100 100 100.00%: 4/20/09 50 50 100.00% YTD Hrs Missed 12.00
2/19/09 20 20 100.00% 5/4/09 50 50 100.00%
2/26/09 20 19 95.00%- 1/0/00 0 0 0.00% Out-of-Town Hrs. 01
3/19/09 20 20 100.00% 1/0/00 0 0 0.00% Current YTD Total 144.00
3/26/09 40 40 100.00%, 1/0/00 0 0 0.00% Prior YTD Total 254.50
4/9/09 20 20 100.00%" 1/0/00 0 0 0.00% Accum. Total 398.50
4/16/09 80 80 100.00% 1/0/00 0 0 0.00% �,GradijAtio
4/20/09 50 50 100.00% 1/0/00 0 0 0.00% Total Re 'd Hrs 576.00
4/23/09 50 50 100.00%, 1/0/00 0 0 0.00% Total Hrs. Short
4/30/09 50 45 90.00%- 1/0/00 0 1 0 0.00%
1 5/4/091 50 50 100.00%" 1/0/00 0 0 0.00%,
1 5/4/091 50 40 80.00% 1/0/00 0 0 0.00%
1 5/11/091 21 16 76.19% 0 0 0.00% f
I 1/0/001 0 0 0.00%. 1/0/00 0 0 0.00%,
I /G /GO 0 0 0.00% 1/0/00 0 0 0.00%
1/0/00
1/0/00
1/0/00
A il l 00 0 00 0 00 0
1/0/00 0 0 0.00%, 1/0/001 0
0 0.00%
1/0/00 0 0 0.00% 1/0/001 0 1 0 0.00%
1/0/00 0 0 0.00% 1/0/001 0 1 0 0.00%
To Number of Quizes given 15 Total Number of Homework assignments 4
Total Number of.Missed Quizes 0 Total Number of Missed assignments 0
2 r
Second 0000%,
-Serh6stet.h(b Grade
iz, de 9 e
Exams Grade Point A vera ge
ernes fer
Date F ;GPA`
rne.- -�Val
E�xarn'N a 7 1
FIRST SEMESTER 95.00% 96.52%1 95.76%
FT 12/31/08 Mid-Term 1 100.00%
12/31/0T8Final 100 85 85.00
I SECOND SEMESTER
I
5/11/09 Mid -Term 1 1 1 100.00%
I C 5/11/09 Final 100 1 go I quo% I E C
COMMENTS: Central Indiana IEC
2131 N. Sherman Dr.
Indianapolis, IN 46218
PH: 317-562-1102
Fax: 317-562-1593
website: www.iec-indy.org
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
361534
INDEPENDENT ELECTRICAL CONTRACTORS Purchase Order No.
2131 N SHERMAN DR Terms
INDIANAPOLIS, IN 46218 Due Date 7/15/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/15/2009 72009 $1,380.00
I hereby certify that the attached invoice(s), or bill(s) -is (are) true and p
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
7112105 /1
Date Officer
VOUCHER 092353 WARRANT ALLOWED
`?61534 IN SUM OF
INDEPENDENT ELECTRICAL CONTRA
2131 N SHERMAN DR �P►
NDIANAPOLIS, IN 46218
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
72009 01- 6040 -03 $1,380.00
Voucher Total $1,380.00
Cost distribution ledger classification if
claim paid under vehicle highway fund