207731 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 365824 Page 1 of 1
ONE CIVIC SQUARE JON ALVERSON CHECK AMOUNT: $125.00
CARMEL, INDIANA 46032 C/O CFo
CHECK NUMBER: 207731
CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 125.00 OTHER CONT SERVICES
Ira 91 :It I
Order Confirmation
Date of Order: February 29, 2012
School Name: SL Vincent Hospital EMS Education
Personal Information:
Name: Jonathan Lee Alverson
DOB: 05/18/1972
Order Number: 9012- 0229 1237 -3000
Package S135:
County Criminal Madison, IN
Jonathan Lee Alverson
Nationwide Sexual Offender Index
Jonathan Lee Alverson
Nationwide Healthcare Fraud And Abuse Scan
Certified Drug Test
Jonathan Lee Alverson
Nationwide Patriot Act
Jonathan Lee Alverson
Social Security Alert
Jonathan Lee Alverson
Residency History
Jonathan Lee Alverson
Medical Document Manager Annual CRR
Total Price: $125.00
Additional Information:
The package price above includes a search of your current county of residence. If any additional counties
are found associated with your name they will be performed at no additional charge.
Notice: This package includes document storage. At the end of the background check order process, you
will be prompted to upload specific documents required by your school for immunization, medical or
certification records.
Important Drug Test Information:
Your drug testing form will be available to you within 24 business hours. You will either receive an email
from CertifiedProfile.com with your registration form attached or you will have receive a notification to
return to your Certified Profile account and read the instructions within your Drug Test To -Do List.
Please contact our Student Services Department with any questions regarding your order at:
(888) 914 -7279 or studentservices @certifiedprofile .corn.
M &I A BRANCH OF BMO HARRIS BANK N A 0060027531
P 0 BOX 2045 Page 1 of 6
MILWAUKEE WI 53201 -2045
www.mibank.com
Cal/ 414 -259 -9929
or 1- 888 464 -5463
For 24 -Hour Account
Information or
Current Rates
MYRANDAALVERSON
JONATHAN ALVERSON Statement Closing Date
7857 s 750 w March 6, 2012
PENDLETON IN 46064 -9760
EVERYDAY Account no.
CHECKING
Beginning balance on February 7, 2012
Deposits and other additions
Checks paid and other subtractions
Ending balance on March 6, 2012
Average balance
Checks paid
Check no. Amount Check no. Amount Check no. Amount
d9=32a Comm
xxx
x
Number of Checks Paid 0950 Amount of Checks Paid
Other subtractions
Date Amount Date Amount Date Amount
Feb 7 Feb 21 Feb 27
Feb 7 Feb 21 Feb 27
Feb 9 Feb 21 Feb 27
Feb 9 Feb 21 Feb 28
Feb 13 Feb 21 Feb 28
Feb 13 Feb 21 Feb 29
Feb 14 Feb 21 Feb 29
Feb 15 Feb 21 Mar 1
Feb 15 Feb 21 Mar 2
Feb 16 Feb 21 Mar 2
Feb 16 Feb 21 Mar 2
Feb 16 Feb 21 Mar 5
Feb 17 Feb 23 Mar 5
Feb 21 Feb 24 Mar 5
Feb 21 Feb 27 Mar 6
Feb 21 Feb 27 Mar 6
Feb 21 Feb 27
Continued on next page
Page 5 of 6
60027531
Daily activity on your account
Date Amount Description Balance
don IX 11 1 1 99 R Is; EMS in
ip
i
a
r- Mar 2 125.00- HECK-CARD-PURCHASE
QRCF Z P_URCNA'SE'T 407314
,GERFIFI EDBACKGR_OUN D GO 91278:1:538 =7�(C
X02- 29_1.2- SEQ:#;206:1.299000 :14
Continued on next page
VOUCHER NO. WARRANT NO.
Jon Alverson ALLOWED 20
IN SUM OF
$125.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 I I 43- 509.00 I $125.00 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
APR 9 2012
r
7 1
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
$125.00
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