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Home My WebLink About218316 03/20/2013 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE s% CARMEL, INDIANA 46032 DEVELOPMENT ATTN ACCT RECV CHECK AMOUNT: $10,016.67 10 N SENATE AVE CHECK NUMBER: 218316 INDIANAPOLIS IN 46204-2277 CHECK DATE: 3/20/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4110000 02/2013 856 . 00 FULL TIME REGULAR 1115 4110000 02/2013 7, 270 . 00 FULL TIME REGULAR 1207 4111000 02/2013 1, 910 . 81 PART—TIME 1301 4110000 02/2013 —20 . 14 FULL TIME REGULAR 133438 -1 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT BENEFIT ADMINISTRATION, 10 NORTH SENATE AVENUE, INDIANAPOLIS, IN 46204-2277 Toil free 1-800-891-6499 Marion County 232-7436 STATEMENT OF BENEFIT CHARGES (FORM 535) CONFIDENTIAL RECORD PURSUANT TO IC 22-4-19-6, IC 4-1-66 Page 1 CITY OF CARMEL ACCOUNT/ ATTN CLERK TREASURER LOCATIORNUMBER 133438 -000 ONE CIVIC SQ FEB, 2013 CARMEL IN 46032-2584 REPORTING MONTH NETCHARGES $10, 016. 67 POSTING DATE MAR-01, 2013 The receipt of this statement (Form 535) does not reopen the question of the claimant's eligibility for unemployment insurance since, before any payments \Mere mndc the :�.mp.'oyei-hard the-upportun"ity— and the responsibility to report any information which could disqualify the claimant. SOCIAL BENEFIT PAID FOR SECURITY YEAR END I CLAIM �TRANSACTION WEEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE I ENDING ACO CHARGED THIS IS NOT A BILL OR A REQUEST FOR MONEY DUE TO THIS DEPARTMENT. It is a statement of benefit charges made to your account during the "reporting" month. At the end of the "posting" month, you will receive a Reimbursable Bill (Form 1067) for these charges and any previous liability still outstanding. *** NEW CHARGES FOR THE REPORTING MONTH 02/13 *** D M HEINZMAN JR 08/24/13 REG 02/19/13 02/16/13 390.00 *** CONTINUE ON NEXT PAGE **** An (*) in the ACQ column denotes a charge resulting from an acquisition of another business. Account/Location Number: 133438 —000 Reporting Month: FEBRUARY, 2013 Page 2 Employer Name: CITY OF CARMEL SOCIAL BENEFIT PAID FOR SECURITY YEAR END CLAIM TRANSACTION WEEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING ACQ CHARGED *** NEW CHARGES FOR THE REPORTZ N�G"� M NTH 02/13 *** D S ALT 12/07/13 REG 02/24/13 02/16/13 _ 87.00 TOTAL NEW CHARGES FOR THE REPORTING MONTH 02/13 10,740.81 *** REVERSED CHARGES/CREDITS FOR THE PRIOR MONTH 07/11 *** G A PARK ��U,/ 02/18/12 REG 02%25/13 07/09%11 54.00CR TOTAL REVERSED CHARGES/CREDIT FOR THE PRIOR MONTH 07/11 444.00CR *** REVERSED CHARGES/CREDITS FOR THE PRIOR MONTH 06/11 *** G A PARK 02/18/12 REG 02/10/13 06/25/11 -------260.00CR TOTAL REVERSED CHARGES/CREDIT FOR THE PRIOR MONTH 06/11 260.000R *** REVERSED CHARGES/CREDITS FOR T E PRIOR MONTH 09/10 *** 315-64-6530 D A HUGHES 08/20/11 REG 02/05/13 09/18/10 20.14CR TOTAL REVERSED CHARGES/CREDIT FOR THE PRIOR MONTH 09/10 20.14CR --------------- TOTAL AMOUNT OF NET CHARGES 10,016.67 *** END OF BENEFIT CHARGE STATEMENT **** 014 An (*} in the ACQ column denotes a charge resulting from an acquisition of another business. 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 I/ �1; I W o r k� �L? 1�t/yl� Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Z4I.6 i Total 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. , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 L 1 r ' �- IN SUM OF $ ON ACCOUNT OF APPROPRIATION FOR bat"), Board Members Po#or INVOICE NO. ACCT#!TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or w U (�j/(J�D : i bill(s) is (are) true and correct and that the ( 6 7 4M 66D /9/0,3/ materials or services itemized thereon for lIDT L 2, 7U,UQ which charge is made were ordered and /(UvG1 Qy Ll received except 20 A'ghatur _&j Title Cost distribution ledger classification if claim paid motor vehicle highway fund 6r