173399 06/10/2009 =c, CITY OF CARMEL, INDIANA VENDOR: 00353099 Page 1 of 1
ONE CIVIC SQUARE JOHN JOKANTAS
s CHECK AMOUNT: $2,027.00
CARMEL, INDIANA 46032 CIO COMM CENTER
C/O COMM CENTER CHECK NUMBER: 173399
CHECK DATE: 6110/2009
DEPARTMENT ACCOU PO NUMBER IN VOIC E NUMBE AMOU DESCRIPTION
1115 4128000 2,027.00 TUITION REIMBURSEMENT
DEPT 8t NO:
UIRgi
INDIANA
WEE L1EYAN MGT -205 -C Professional Communication 3.00 A
U N I V E R S IT Y
RECORDS OFFICE
4201 South Washington Street
Marion, Indiana 46953
John M. Jokantas
1660766
02/12/09 03/18/09
NA
a f HOURS TOTAL NON- QUALITY QUALITY QUALITY GRADE
SUMMARY ENROLLED EARNED HOURS HOURS POINTS POINTAVG.
CURRENT
CUMULATIVE
38.00 1 98.00 0.00 35.00 139.10 3.97
Indiana Wesleyan University lumu lative GPA reflects hours earned at Indiana Wesleyan University only. Calculation for Baccalaureate honors may include
ansfer hours. Current status of Baccalaureate honors: e
is a Christ centered
academic community RADED HOURS 98.00 (min. 80 req.; 40 hrs. IWU) HONORS GPA 3.50 3
commit to ALL ERRORS MUST BE REPORTED WITHIN TWO WEEKS.
changing the world EXPLANATION OF GRADES, POINTS, AND CREDIT HOURS THE UNIT OF CREDIT IS THE SEMESTER HOUR.
by developing students A 4.0 Excellent WF Withdrawal while failing Grade point average based on quality points
A- 3.7 W Withdrawal while passing divided by quality hours. Total earned hours
in character, scholarship B+ 3.3 1 Incomplete count toward graduation requirements.
B 3.0 Good NR No grade report given
and leadership. B- 2.7 CR Credit Equivalent to C or above
C+ 2.3 NC Non Credit Equivalent to below C
C 2.0 Average AU Audit
C- 1.7 NA Failure to Audit
TRANSCRIPT INFORMATION D+ 1.3 0 Outstanding
To request an official transcript, information is D 1.0 Passing S Satisfactory
available by phone at 765- 677 -2966 or online at F 0.0 Failure U Unsatisfactory
http: /www.indwes.edu /records /transcripts.htm. IP In Progress
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COURSE DESCRIPTION HOURS GRADE
INDIANA
WES L.EYYAN
BIL- 102 -EE New Testament Survey 3.00 A
UN I V E RS I T Y
RECORDS OFFICE
4201 South Washington Street
Marion, Indiana 46953
';,John M. Jokantas
1660766
03/10/09 04/13/09
f SUMMARY HOURS TOTAL NON- QUALITY QUALITY QUALITY GRADE
ENROLLED EARNED HOURS HOURS POINTS POINT AVG.
CURRENT
CUMULATIVE
U
Indiana Wesleyan University Cumulative GPA reflects hours earned at Indiana Wesleyan University only. Calculation for Baccalaureate honors may include D
q
is a Christ- centered transfer hours. Current status of Baccalaureate honors: D
academic community GRADED HOURS 104 00 (min. 80 req.; 40 hrs. IWU) HONORS GPA 1 52 3
committed to ALL ERRORS MUST BE REPORTED WITHIN TWO WEEKS.
changing the world
EXPLANATION OF GRADES, POINTS, AND CREDIT HOURS THE UNIT OF CREDIT ISTHE SEMESTER HOUR.
by developing students A 4.0 Excellent WF Withdrawal while failing Grade point average based on quality points
A- 3.7 W Withdrawal while passing divided by quality hours. Total earned hours
in character, scholarship B+ 3.3 1 Incomplete count toward graduation requirements.
B 3.0 Good NR No grade report given
and leadership. B- 2.7 CR Credit Equivalent to C or above
C+ 2.3 NC Non Credit Equivalent to below C
C 2.0 Average AU Audit
C- 1.7 NA Failure to Audit
TRANSCRIPT INFORMATION D+ 1.3 0 Outstanding
To request an official transcript, information is D 1.0 Passing S Satisfactory
available by phone at 765- 677 -2966 or online at F 0.0 Failure U Unsatisfactory
http: /www.indwes.edu /records /transcripts.htm. IP In Progress
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71 A :1 d
INDIANA Receipt Number: 000285833
WE C r G YAK T Receipt Date: 05/14/09
U N I V E R S I T Y
i
Adult and Graduate Studies
i John M. Jokantas Accounting Services
634 W 136th St 1900 W 50th Street
Carmel, IN 46032 Marion, IN 46953
(765) 677 -2878
1 -800- 621 -8667
Received From: J John M. Jokant a
as
General Elective Payment
Description: MGT205 $1108
BIL102 $919
Payment Type Amount
VS 294 2,027.00
rte++,, 1 r5
Total:' 2,027.00
THIS IS YOUR RECEIPT
Please Retain For Your Records
Thank You
City Of Carmel
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please print. Submit completed form to Department Head rip or to commencement of course.)
Employee Name �b�ls
Department COMM id n i r. J '(UrLT SSN Date LAO '!a
Educational Institution
Name of Course A l& p+��Q/��'>92 �u! V e v Credit Hours
Starting Date of Course (month day /year)
By signing below, I signify that I understand the following:
The tuition reimbursement program is subject to the terms of Carmel City Code,.Section 2 58.
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 an original itemized receipt
or other proof of purchase that links these books to this particular course.
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 reimbursement payments is subject to federal law, which may change from time to time:
Employee Signature Date T 1
Part II (to be completed by Department Head)
(Submit to Human Resources)
By signing below, I certify that the applicant will have been employed 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 of the course. The final claim will be paid from. my
department's budget, subject to the terms of Section 2 58 of Cannel City Code.
Department Head Signature
P g Date 2G rAti,2
Part III (to be completed by Director of Human Resources)
Final Approval Date 1 5 D
If denied, reason for denial
The tuition .reimbursement program covers only fuli- semester courses offered .through a degrce- granting institution
accredited by the North Central Association of Colleges and Schools or an equivalent regional acereditor.
An application will not be considered complete unless a course description from the school's literature is attached.
City Of Carmel
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please print. Submit completed form to Department Head p to commencement of course.)
Employee Name T- M Vak
Department Caa3mua1 i on SSN Hire Date 08' t:�—C6�.
Educational Institution* Zn el f and L) fro ycza-
Name of Course btncL I COM kn i �g'kons Credit Hours
Starting Date of Course (month/day /year)
By signing below, I signify that I understand the following:
The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -58.
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 an original itemized receipt
or other proof of purchase that links these books to this particular course.
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 reimbursement payme s subject to federal law, which may change from time to time.
Employee Signature Date 1/ 1 7 Y
Part II (to be completed by Department Head)
(Submit to Human Resources)
By signing below, I certify that the applicant will have been employed full -time by the City for at least one (l)
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 of the course. The final claim will be paid from my
department's budget, subject to the terms of Section 2 -58 of Carmel City Code.
Department Head Signature Date fG ✓;9W Zo o
Part III (to be completed by Director of Human Resources)
Final Approval Date dig b
If denied, reason for denial
The tuition reimbursement program covers only full- semester courses offered through a degree granting institution
accredited by the North Central Association of Colleges and Schools or an equivalent regional acereditor.
An application will not be considered complete unless a course description from the school's literature is attached.
Prescribed by State Board of Accounts City Form fro. 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))
05/14/09 I I I $2,027.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
John Jokantas
IN SUM OF
634 W. 136th Street
Carmel, Indiana 46032
$2,027.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1115 41- 280.00 $2,027.00 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
Monday, June 08, 2009
Dir
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund