HomeMy WebLinkAbout213675 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 362110 Page 1 of 1
1 � ONE CIVIC SQUARE BRIAN TOLAN CHECK AMOUNT: $34.17
®t� CARMEL, INDIANA 46032 606 S UNION ST
WESTFIELD IN 46074 CHECK NUMBER: 213675
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 34 . 17 OTHER EXPENSES
Kern,
Here is a copy of my new water license (issued June 2012). A copy of the credit card
receipt from the on-line renewal is also included.
The transaction posted on 6/11/12 for the amoun f$34.17 wit a payee as
IN PROFESSIONAL LLC.
I believe that the license itself was $30.00.with the additional $4.17 being on-line renewal
fees.
Thank You,
Brian Tolan\ WT062953
Carmel Water Treatment Y ,
_;re�
YoUr Drinkiw-� Water t)perator rcrlilii:aliun, nunlhcr WT0l6?1L)5;• i;enclosed.
INFORMATION �11'
IMPORTANT CERTIFICATION � � I
ADDRESS CHANCE: Ii is your responsihillty to notch the Indiana Department of linvironmcnial Nlanagcmcnt ol!anv
cham,c of address. You may c:-inad us at or I"ax to(3l7)?34-7462 or call (317)234-7431.
NAME CHANCE: A name changc request must he auhntittcd in vrhino. Mail iw Indiana Department of
I:rtvi roll nlenlal millialen1cm, C1llice ol'Watcr(Quality. Drinkirl`r Water Branch - Mail Code 66-34, 100 N. Scnale Av�c.,
j Indiuoapolk, 1N 462-04-2251 -or you c.)n fax to (317)-?34-7462- II I
CERTIFICATION RENEWAL-The Drinking Watcr Opemlor Certification Pro(urnm will I'orkv-,ird a certification I i �
t t
rcnewal notice to the ccrti tied operator aneS address provided no later than INrty days prior to the expiration of your 1
a
cerliGrttion. i� Ij 1
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,�" . UI<I'pk i1Nhn1'OF I;S'v'Ik�)�;1tF.N 1'Af.NI4NAGI;pIF.V'I
7
- n,'i„km_�tF;ucrMr,,nch— G(-;d
InJianap,di,.IN 40-204---s l I -
r;
certificate Nu mher Fapirati(iri Elate i
' ��'7'06?953, 06/311/21115 I i Your Ccstilication xyill cxpirr on 1i6i311%211 I J. if you have any
questions,please contact Kuhy KCslar al 1317) 234-7431 oremail j
BRIAN S. TOLAN +
is qualified as a ;,' i rkcslar(ir?idem.in. ov. I
I Grade WT3
I i <,Wateffreatmerit Pla6t Operaor
s
INDIANA DEPARTMENT OF.ENVIRONMENTAL MANAGEMENT."/
a'± Drinkinb Water Branch—Mail Code,66=34'x={ t -
;a J, 100 N''Senate Avenue
Indianapolis, IN 46204-2251
' �• ,�-. . .11 lad = .
Water-,-,Works Operator Certificate
_
This is to ccrtifv that
1A °-I&Jt=r. ..;rtiLi
BRIAN S. TOLAN
j� has fulfilled the-reyuirements-for Certificatloi as rNdifeed by the Laws'of the State' ` � N
of Indiana, and-is duly certified as j I
1 a Grade WT3-Water Treatment PlantOp, or 1 I
In the State of Indiana and:is entitled to the rights and privileges as provided by the State of Indiana
_ and subject to the'}-)owers of revocation as vested in said Agency- 41 !1
I In T_estiiriony Witncss the Signature of the Commissioner, I f,
Ilil I
1
11/021/2006
i. I
Thomas W. Easterly
Certificate Number: WT062953
Commissioner t i
ORCHam BaNK7
Orchard Bank Platinum.. +Account Statement
Account Number'
BRIAN S TOLAN- Valued Cardmember Since 2010 Page 2 of 2 From May 20,zv+c lV
IN
ca�w�
--——0611-1112--06!13/12--IN PROFESSIONAL LIC--31723321.10 _IN-_ .________._._ _ ___MT1 21 6501 1 400001 0034476 —$34.17
502,7AW -— W x:.25
i
t
Total Purchases For This Period
_ _
._ .- _.. Fees_ --
z Trans Date 'Post Date' Description-6t Fee-s Reference Number: - f� Amount
z
z 06/19/12 06/19/12 rc, -=A_LL�
Z
z Total Fees for This Period
Z
Interest Gharged _
4
N Description of Interest Charge �� Amount
INTEREST CHARGE ON CASH ADVANCES �! i{ $0.00
INTEREST CHARGE ON PURCHASESj , 1 $0.00
INTEREST CHARGE ON BALANCE j j; $0.00
TRANSFERS
if i
Total Interest For This Period j $0.00
2012 Totals Year to date - i
Total fees charged in 2012 i
I I
Total interest charged in 2012 $0.00
I:II" ll{
tr�terest,Cha�geCalaulatxin
Your Annual Percentage Rate(APR)is the annual interest rate on your account. 10: 111
-
Type of Balance Annual Percentage Rate(APR) Balance Subject to Interest Rate j Interest Charge
I
{i PURCHASES 00001 19.99%(v) $0.00 it�^ $ .00
I CASH ADVANCES 80001 20.90%(v) $000 $0.00
BALANCE TRANSFER 19.99%(v) $000
71111 � 4 i
I �
® v=Variable Rate ;,4
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Customer News:;:
-
Secure Registration at:orchardbank.com/register.Enroll in paperless statements,track spending,pay your bill and update personal information online with Account
Access.
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1-.05905 10 Ooaclwo 0 STNIT07 D H 1555c7 GDS/ �i
VOUCHER # 122278 WARRANT # ALLOWED
TBRIAN IN SUM OF $
BRIAN TOLAN
DISTRIBUTION OFFICE
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
10312 01-6040-03 $34.17
f
I
Voucher Total $34.17
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
TBRIAN
BRIAN TOLAN Purchase Order No.
DISTRIBUTION OFFICE Terms
Due Date 10/3/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/3/2012 10312 $34.17
I 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
.o1>/iL
Date Officer