HomeMy WebLinkAbout206619 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 362146 Page 1 of 1
ONE CIVIC SQUARE C P E S C
CARMEL, INDIANA 46032 49 STATE STREET CHECK AMOUNT: $100.00
MARION IN 28752 CHECK NUMBER: 206619
CHECK DATE: 2/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4355300 3668 100.00 ORGANIZATION MEMBER
John Gharrity Thomas
CPfSC 3668
11576 Creek Side Lane
Carme IN 46033
RENEWAL FEES DUE
Annual Renewal Fee: $100.00 Late Fee: $25 Total Amount Due: $125.00
PROFESSIONAL DEVELOPMENT AFFIRMATION
Current Period: 12/31/2008 12/30/2011........... Requirement: 60 PDUs per 3 Year Period Minimum of 2 Categories
Review your professional development records and check either YES or NO in response to the following statement:
I HAVE COMPLETED PROFESSIONAL DEVELOPMENT REQUIREMENT FOR THE CURRENT PERIOD: )(YES NO
Signs and date in the space below.
John Gharrity Thomas Date
0 YES means that you have completed the professional development requirement for your current period. We will
advance your PDU period to the next three -year block, and if your renewal fees are current we will issue a new ID card.
0 NO means that you have NOT completed the professional development requirement for your current PDU period. The
suspension of your CPESC Certification will not be lifted and we will NOT issue a new ID card. Please contact our office as
shown on the front of this notice and ask for guidance.
If you need assistance in determining whether you have met the professional development requirement, please contact our
office as shown on the reverse side of this letter. Remember, it is a violation of the Code of Conduct and Ethics to
knowingly provide false information to the CPESC Administrative Office. (See CPESC Certification Procedures and
Standards, Article II, Section 4, Item B.2 for details.)
PAYMENT INFORMATION
Payment amount: 2S, Oo (in US dollars)
Payment method: )'Check /Money Order Visa American Express MasterCard Discover
Make check payable to CPESC, Inc. in US funds.
Credit Card Number:
Expiration Date: m m Card Security Code:
Name of Card Holder
Signature of Card Holder
Address of Card Holder
P ROFf SS,Oy9<
CrZSC, 0 0
Inc Z
An EnviroCert International Organization p CPESC o
D SED\M��
February 1, 2012
JOHN GHARRITY THOMAS
11576 CREEK SIDE LANE
CARMEL, IN 46033
Dear John Thomas:
RE: CPESC Certification
Your CPESC Certification has been suspended by action of the CPESC Council because it was not renewed in
accordance with CPESC, Inc. policy. Effective immediately, discontinue use of the CPESC designation. This action
has been taken for nonpayment of renewal fees, and failure to affirm professional development.
To lift the suspension, you must remit renewal and late fees, and affirm your professional development using
the form shown on the reverse side of this letter. If your CPESC Certification remains in a suspended state for
three (3) years, it may be revoked by action of the CPESC Council. Once revoked, you would need to go through
the complete application and examination process to regain certification.
The policies governing suspension can be found on the CPESC, Inc. web site (www.cpesc.org) under CPESC
Certification Procedures and Standards, Article II, Section 4.
If you believe that you have received this notice in error or if you need assistance in locating the suspension
policy, please contact our office immediately.
Sincerely,
Gina Burleson
CPESC Program Manager
(828) 655 -1600, ext. 131
gina @cpesc.org
49 State Street Marion, NC 28752 Phone: 828.655.1600 Fax: 828.655.1622 www.ci3esc.ora
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
CPESC
Purchase Order No.
49 State Street
Terms
Marion, NC 28752
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
n/a CPESC #366 1- Yr Certification renewal John Thomas $100.00
Total $100.00
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.
CPESC ,n r-1 U4L-, C; I ALLOWED 20
49 State Street IN SUM OF
M NC 28752
$100.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or DEPT INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
n/a CPESC #3668 y3 36b $100.00 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
20
Signature
C�fii ��e�n>Z sue"
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund