HomeMy WebLinkAbout173524 06/10/2009 F CITY OF CARMEL, INDIANA VENDOR: 361349 Page 1 of 1
ONE CIVIC SQUARE ERIC ROBINSON
CARMEL, INDIANA 46032 6119 DADO DRIVE CHECK AMOUNT: $55.00
NOBLESVILLE IN 46062 CHECK NUMBER: 173524
CHECK DATE: 6/10/2009
DEPARTMENT ACCO P O NUMBER INVOICE NUMBE AM OUNT DESCRIPT
651 5023990 051909 55.00 OTHER EXPENSES
a CITY OF CARMEL Expense Report (required for all travel expenses) A
\HDIAN�
2008 mileage reimbursement rate is 58.5 cents /mile
EMPLOYEE NAME: ERIC ROBINSON DEPARTURE DATE: 5/19/2009 TIME:
DEPARTMENT: Utilities /Sewer RETURN DATE: TIME:
REASON FOR TRAVEL: 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 Parking Breakfast Lunch I Dinner I Snacks Per Diem
5/19/09 COLLECTION SYSTEM EXAM $55.00 $55.00
$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
$0.00
$0.00
0.00
Total $0.00 $0.00 $0.00 $0.001 $0.001 $0.001 $0.001 $0.00 $0.00 $0.00 $55.00
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 5/27/2009 Page 1
1
Tuesday, May 19, 2009
Eric Robinson
6119 Dado Dr.
Noblesville, IN 46062
Eric,
This letter is to inform you that you received a passing score of 94 on the recent
IWEA Collections Exam. Enclosed you will find your certificate as well as your
individual mastery report from the exam. I have also enclosed additional
information for reference material for this exam.
Thank you,
Brian W. Miller
IWEA Collections Committee
(260) 427 -5784
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Indian Environ s iationN
a TnTa to r Association
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♦"D ��`Q`i� `a. ice`
-x, This Certifies That�7'
yam: GJ
Eric S. Robinson
r' has fulfilled the req for Voluntary ertification as a Wastewater
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Collection System Operator in accordance with the requirements established by the
.y IWEA Collection System Committee, and is hereby granted��•
'1 Certification as a>
-;r Class CS
Wastewater Collection System Operator �x{4
In testimony whereof, we have hereunto put our hands
r_�y~ this 29th day of April, 2009
y Certificate No. I 09 /06 '�-jf
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Certification Program AdministratorY
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APPLICATtJ €TN'TARY
OPE12A'TIP N
Administered by the Indiana Water Environme oms:Collection System Committee
o} �N
NOTE: A complete application form is required including a $SS 00 (ngn 7i e fqr class I II examinations and 865.00 (non
refundable) application fee for class III IV examinattons,.iletarled or's and applicant's signatures, and verification of
your post high school com lication f orm the fi nal !in date educational qual� cations attached wtll The app resuhlt„cattQ,d� d' Checks shall be payable to 1WEA. Failure to
return a a ted PP b! fi g al ratte
:yQrrrs l� t oration and jorfeitrtre of your application fee. ALL
EDUCATIONAND EXPERIENCE REQUIREMENTS MUSTBIi14T A FAILURE TO MEET OR VERIFY EITHER OF
THESE WILL MS ULTININELIGIBILTYFOR THEEXAWNATTi01l
All app lications must be received prior to the 2nd Thurs
app p day to March fo thy: and the 2ndThursday in September for the October
Examinadotr
CERTIFICATION EXAMINATION APPLICATION; JeCS-II CS -III CS-W (CIRCLE ONE)
DATE
:ter r� t
I. APPLICANT INFORMATIONS
i
Last
r 2 D Middle
��k5 ��'b
B. MAILING ADDRESS Of
City Zip Code County
C. WORK PHONE NUMBER t �'I�ON)- rY ER: 1 11Q \3
Area Code &Number Area Code Number
D. Have you previously applied for a Collection System Certtficate t h A YE$ x NO (CIRCLE ONE)
E. What certifications do you presently hold? List all that apply A o
CertrficattbdNutnber 'f State Grade Class
Water Treatment
n 4 w. t t
Water Distribution .q3#1 .n a
Municipal Wastewater Treatment
Industrial Wastewater Treatment` P 1
x;..
Wastewater Collection System
Others
II. EDUCATION AND TRAINING f TM r t f Y
rY r,
A. High School: Name of School:
Years Attended a Date of Gradui}It
fry
B. College: Name of School
Years Attended: Date of Graivattoq ;x
A'
C. NOTE: Attach verification of our post-h- d sc o01 u ua6 to s Copies of college transcripts or certificates of
completion for courses related to wastewater treatait� b Qroof of educational qualifications You may
list training courses, short courses, or other cauiscs m the $`e 1d' at on have attended on Page 4. Include only post high
fi
kk
school information a
r x
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tg
yyii s �fi
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R xR t r fit: c�'r«
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x b.
T �r
III. WORK EXPERIENCE HISTORY
List your present employment first then any additional e a detailed description of your collection system work
experience as designated below. If you are not a fu11m 0 erator, sped the average number of hours per
week that are. spent in the actual operation artd mqt r istem NOTE: If you are applying for a Class
III or IV examination clearly 'de ine AND docta»rei" f e and quaRflcadons su ervision does not
necessarily dictate "in- charge" M experience).' F y
W
CURRENT EPLOYMENT:
Current Employer. CAF 2�Q_X\ X�L Dates 1 to Present
Job Title:
a Job Description: cl>lk
rte
Collection System Duties: fs
Classification of Wastewater Treatment Plant: Municipal III V (Circle One)
Indus tria
l A B C D
Wastewater Treatment Plant Capacity: Gallcans
Supervisor's Name: T c
Address: p
Phone o.:
a ft
3 g 1
4�'x Sys s,
PRIOR EMPLOYMENT:
r'
Past Employer: o
T
F Job Title F�
fl Job Description: l2-� y\
Collection System Duties:
Classification of Wastewater Treatment Plant: Municipal r VIII IV (Circle One)
Industrial" O A rt B C D
Wastewater Treatment Plant Capacity:
Supervisor's Name:
Address: t
Phone No.:
x
of Tsy:
j°s 4^n
IV. ADDITIONAL EDUCATION (Attach Copy of ComploVesattand/o Transcripts)
1. NAME/DESCRIPTION OF COURSE:;.
(Location)
P-4079- (College Units or Class Hours)
2. NAME/DESCRIPTION OF COURSE: M
(Location) (College Units or Class Hours)
O
w f U
3. NAME/DESCRIPTION OF COURSE: a �r�r
(Location) (College Units or Class Hours)
41
4.. NAME/DESCRIPTION OF COURSE:
(Location) (College Units or Class Hours)
J
w
k
a
V. SUPERVISOR'S VERIFICATION OF CURREI7C �Qmpleted by present Employer)
I hereby verify that the information contained in the current,em Y w )cation made by C �c S NS�IJ
to be true and correct to the)iesk o
r Date
Supervisor's Signature
r A Y-A 011C4 A Title
PrintedK
i
VL SIGNATURE OF APPLICANT
I, the undersigned, certify that I am the above that�y g ration contained in this application
M0' are xrue to the best of my knowledge and belief, that I s�e�presentations may result in
meli ibiR for the examination's lied for I also cons nt ti e Ip em: record and other
r g ty PP �P.:•Ym
quali ations in related activities fo the purpose of venficattcS o e certificate for which I have applied.
Srgnature ofApphcant)
61 "i npOet ed a !ien ion form with check/money order for.`prope camia should be returned to:
4, Gary Merriman or Brian Miller
WPCM/STM Department
515 East Wallace Street
Fort Wayne, IN 46803
NOTE: DUE DATE FOR APPLICATIONS, MARCH'10, 200 F4DR S]E' :SEPTEMBER 8, 2009 FOR FALL EXAM
LATE APPLI(,ATYONS 4Y1T; �lal0�
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Z INDI APOLIS INDIANA 46204
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Account History Page 2 of 3
Account History Pagel of 3
Member Number: 51.094
Member Name: ROBINSON, ERIC S
Account #30 Detail 1 D*
Account Title Share Draft Account Balance
Account Number 30 Available Balance
Account Type Share Draft 2009 Interest $0.00
2008 Interest $0.00
Account #30 History
04-01 -2009 to 04 -2009
04 -02 1815 Withdrawal S are Dran 55.00
2009 1815
04 -01- ACH W/D
https:/ /www.gifeuhb.org /onlineserv/HB/ Summary. cgi? nextStartMonth= 04 &nextStartDay 5/27/2009
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
T1004
ROBINSON, ERIC Purchase Order No.
CARMEL WASTEWATER Terms
Due Date 6/2/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/2/2009' 051909 $55.00
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
Date Off er
VOUCHER 095747. W /\RRANT ALLOWED
T1004 IN SUM OF
ROBINSON, ERIC
CARMEL WASTEWATER
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
051909 01- 7042 -06 $55.00
Voucher Total $55.00
Cost distribution ledger classification if
claim paid under vehicle highway fund