217122 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 366017 Page 1 of 1
ONE CIVIC SQUARE ENVIROCERT CHECK AMOUNT: $150.00
CARMEL,INDIANA 46032 49 STATE STREET
MARION NC 28752 CHECK NUMBER: 217122
CHECK DATE: 2113/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
211 4462838 150 . 00 STORM WATER PHASE II
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C E R T I F I E D
Erosion
.Sediment'
CESSWI •
Rene
wal I\Totl' Storm Water
ce
2013 - 2014
201
4
. - 1 N S P E -C 'T 0 R ru
•
KURT MAXWELL ANDERSON
ONE CIVIC SQUARE
Amount Due: $75.00
DEPARTMENT OF ENGINEERING Date Due: March 31, 20'13
CARMEL, 1N,'.46032
RETURN THIS FORM WITH YOUR PAYMENT
Renewal Fee Details:
CESCknn#r 1237
I
................Years: 1...............
Ar7ount Cue:$75.00.........
Status:Active
Professional Development Affirmation:
Current Period;3 23
/ ,./2011-3/22/2013...............
Due Date forPDUs:3/23/2013 ..
....Requirement:20 PDUs per 2 Year Period
Review your training records and select either YES or NO in res o
p nse to th I
e following statement:
I HAVE COMPLETED PROFESSIONAL DEVELOPMENT REQUIREMENTS FOR THE CURRENT PERIOD:
. d
Sign and date in the space below. (See back page for explanation.) �ES NO
Kurt Maxwell A
nde�
s
on .. I
Date
Information Update: (Please mark this notice with any changes to your contact in
Business Phone: 3 _ formation.)
( 11)571 2308
Ext.
Fax: (31 1-2439
i
Home Phone: (317)402-9774
I
Email: kanderson@carmel.in.gov
-Please I
list any professional titles that you currently hold(for example, PE,'RLA): '
I
r
Payment Information
ENTER YOUR PAYMENT INFORMATION ON THE REVERSE SIDE OF'THIS NOTICE.
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s
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49 STATE STREET MARION, NC 28752 PHONE: 828.655.1600 FAX: 828:655.1622 WWW,CESSWLORG
CESSWI,INC.IS AN ENVIROCERT INTERNATIONAL,INC.AFFILIATED ORGANIZATION
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C E R T I F 1 E D
II Municipal Se ar
cMS4S Renewal State
ewal Notice Storm Sewer System
DUMP NO WASTE
2013 - 2014
S4S"'
.S P E C I A l / S T „
JOHN GHARRITY THOMAS
11576 CREEK SIDE LANE
A
CARMEL, IN 46033 Date Due: $75.00
Date Due: March 31, 2013
Renewal Fee Details: RETURN THIS FORM WITH YOUR PAYMENT
CMS4S#139
Annllal Rata 575
Q�'1n1�n/•�l win: C7C
QQ......................c+-,+ n
Professional Development Affirmation: 4 J y"Vc
Current Period: 3/23/2011
-3/22/2013 ....................................................
Due Date for 30 PDUs:3/23/2013 Requirement: 30 PDUs per 2 Year Period
Review your training records and select either YES or NO in response to the
I HAVE COMPLETED PROFESSIONAL DEVELOPMENT REQUIREMENTS FORT following statement:
Sign and date in the space below. HE CURRENT PERIOD:
(See back page for explanation.) YES ONO
John Gharrity Thomas
Information Up date: ( Date
Please mark this notice with any changes to your contact in
Business Phone: (317)571-2314 formation.)
Ext.
Fax: (31 1-2439
Home Phone: /7171,�1 C_11QE
Email: ithomas@carmel.in.gov
Please list any professional titles that you currently hold(for example, PE, RLA):
Payment Information
ENTER YOUR PAYMENT IKFORMATION ON THE REVERSE SIDE OF THIS NOTICE.
49 STATE STREET MARION, NC 28752 PHONE: 828.655.1600 FAX: 828.655.1622 www,CMS4S.ORG
CMS4S,INC.IS AN ENVIROC TT 1N-1 RNATIONAL,INC.AFFILIATED ORGANIZATION
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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:
rates per day, kind of service, where performed,m
P y, umber of hours, rate per hour, nu p ed, dates service rendered b w
tuber of units, price per unit etc. � y whom,
Payee
EnviroCert International
7Terms Order No.
49 State Street
Marion, NC 28752
Date Due
Invoice Invoice
Date Description
Number (or note attached invoice(s) or bill(s)
1/0/1900 0 Cesswi Renewal-Kurt Amount
1/0/1900 0 CMS4S Renwal-John Thomas $ 75.00
$ 75.00
Total
i
1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited samen accordance 150.00
with IC 5-11-10-1.6.
,20
Clerk-Treasurer
i
i
VOUCHER NC WARRANT NO.
EnviroCert International ALLOWED 20
49 State Street IN SUM OF $
Marion, NC 28752
$ 150.00
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITL AMOUNT
oEPTa I hereby certify that the attached invoice(s),
0 0 211-4462838 s 75.00 or bill(s) is (are)true and correct and that the
materials or services itemized thereon for
0 0 211-4462838 s 7500 which charge is made were ordered and
received except
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2/11/2013
Signature
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City Engineer
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Cost Distribution ledger classification if Title
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claim paid motor vehicle highway fund
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