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Home My WebLink About218358 03/25/2013CITY OF CARMEL, INDIANA ONE CIVIC SQUARE CARMEL, INDIANA 46032 VENDOR: 146500 INDIANA DEPT OF WORKFORCE DEVELOPMENT ATTN ACCT RECV 10 N SENATE AVE INDIANAPOLIS IN 46204 -2277 Page 1 of 1 CHECK AMOUNT: $1,628.72 CHECK NUMBER: 218358 CHECK DATE: 3/25/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 R4110000 29276 676277 1,628.72 UNEMPLOYMENT FEES 676277 -1 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT BENEFIT ADMINISTRATION, 10 NORTH SENATE AVENUE. INDIANAPOLIS, IN 46204 -2277i Toll free 1- 800 - 891 -6499, Manon County 232 -7436 STATEMENT OF BENEFIT CHARGES (FORM 535) CONFIDENTIAL RECORD PURSUANT TO IC 22- 4 -19 -6, IC 4 -1 -66 CARMEL CLAY BOARD OF PARKS AND RECREATION 1411 E 116TH ST CARMEL IN 46032 -3455 RECEIVED MAR 18 2013 Page 1 ACCOUNT/ LOCATION NUMBER 676277 -000 REPORTING MONTH FEB, 2013 NET CHARGES $1,628.72 POSTING DATE MAR-01 , 2013 The receipt of this statement (Form 535) does not reopen the question of the c aimant's eligibility for _unemployment insurance_since, before any payments were made the employer had the opportunity and the responsibility to report any information which could disqualify the claimant. SOCIAL SECURITY NUMBER EMPLOYEES NAME BENEFIT YEAR END DATE CLAIM LEVEL TRANSACTION DATE PAID FOR WEEK ENDING ACQ AMOUNT 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 * ** K M JONES JR 04/27/13 REG 02/17/13 02/16/13 115.61 TOTAL NEW CHARGES FOR THE REPORTING MONTH 02/13 : 1,628.72 TOTAL AMOUNT OF NET CHARGES : 1,628.72 * ** END OF BENEFIT CHARGE STATEMENT * * ** Purchase ,-v U Description �—�- IN . G.L.# 111%5 — I—DI- 4- Ittco0 BUd�t Iull—C�'i m� '•' Line esc Purchaser e Approval Date An ( *) in the ACQ column denotes a charge resulting from an acquisition of another business. ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 146500 Indiana Dept. of Workforce Development 10 North Senate Ave., SE106 Indianapolis, IN 46204 -2277 Purchase Order No. Terms Date Due Invoice Date Invoice Number Description (or note attached invoice(s) or bill(s)) PO # Amount - 3/1/13 676277 Unemployment charges Parks Acct - Feb'13 29276 $ 1,628.72 Total $ 1,628.72 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 C \erk-Cceas\ \%\ Voucher No. Warrant No. 146500 Indiana Dept. of Workforce Development Allowed 20 10 North Senate Ave., SE106 Indianapolis, IN 46204 -2277 $ 1,628.72 ON ACCOUNT OF APPROPRIATION FOR 101 - General Fund PO# or Dept # INVOICE NO. ACCT # / TITLE AMOUNT 29276 676277 4110000 $ 1,628.72 $ 1,628.72 Cost distribution ledger classification if claim paid motor vehicle highway fund In Sum of$ Board Members I 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 21 -Mar 2013 Signature Accounts Payable Coordinator Title VOUCHER NO. WARRANT NO. IN Department of Workforce Development Benefit Administration 10 North Senate Avenue Indianapolis, IN 46204 -2277 $1,910.81 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO# / Dept. INVOICE NO. ACCT #/TITLE AMOUNT 1207 133438 -000 41- 110.00 $1,910.81 Cost distribution ledger classification if claim paid motor vehicle highway fund ALLOWED 20 IN SUM OF $ Board Members I 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 Thursday, March 21, 2013 Director, Brook kSire Golf Club Title VOUCHER NO. WARRANT NO. Indiana Department of Workforce Development Benefit Administration 10 North Senate Avenue Indianapolis, IN 46204 -2277 $856.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# / Dept. 1110 INVOICE NO. ACCT #/TITLE AMOUNT 41- 100.00 $856.00 Cost distribution ledger classification if claim paid motor vehicle highway fund ALLOWED 20 IN SUM OF $ Board Members I 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 Wednesday, March 20, 2013 Chief of Police Title 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 Date Invoice Number Description (or note attached invoice(s) or bill(s)) Amount 03/01/13 unemployment charges - Herron / Park $856.00 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