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Home My WebLink About221366 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE c CHECK AMOUNT: $553.37 s. 4`io CARMEL, INDIANA 46032 DEVELOPMENT ATTN.ACCT RECV 10 N SENATE AVE CHECK NUMBER: 221366 INDIANAPOLIS IN 46204-2277 CHECK DATE: 7/2/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 R4110000 29276 676277000 553 . 37 UNEMPLOYMENT FEES 676277 . -1 1 DEPARTMENT OF WORKFORCE DEVELOPMENT JUN 17 2013 BENEFIT ADMINISTRATION, 10 NORTH SENATE AVENUE, INDIANAPOLIS, IN 46204-2277 Toll free 1-800-891-6499 Marion County 232-7436 Ry.. STATEMENT OF BENEFIT CHARGES (FORM 535) CONFIDENTIAL RECORD PURSUANT TO IC 22-4-19-6, IC 4-1-66 Page 1 CARMEL CLAW BOARD OF PARKS ACCOUNT/ AND RECREATION LOCATION NUMBER 676277 -000 1411 E 116TH ST REPORTING MONTH MAY, 2013 CARMEL IN 46032-3455 NETCHARGES $553 . 37 POSTING DATE JUN-07 , 2013 The receipt of this statement (Form 535) does not reopen the question of the claimant's eligibility for unemployment insurance since_; before tiny -2-me.-ts .erc ,;,ade a aimpl©ye.- had tiie opportunity and the responsibility to report any information which could disqualify the claimant. SOCIAL BENEFIT PAID FOR SECURITY YEAR END CLAIM RANSACTION WEEK AMOUNT NUMBER EMPLOYEE'S NAME DATE LEVEL DATE ENDING ACQ 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 05/13 *** B PENTON 01/11/14 REG 05/27/13 05/25/13 57.37 --------------- TOTAL NEW CHARGES FOR THE REPORTING MONTH 05/13 : 553.37 --------------- --------------- TOTAL AMOUNT OF NET CHARGES : 553.37 *** END OF BENEFIT CHARGE STATEMENT **** lam Vr t ch J ma-Y ,8 0),000c) Fol/ f i rkY c r(3/chi- 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 Purchase Order No. 146500 Indiana Dept. of Workforce Development Terms 10 North Senate Ave., SE106 Date Due Indianapolis, IN 46204-2277 Invoice Invoice Description Date Number (or note attached invoices) or bill(s)) PO# Amount 6/7/13 676277000 Unemployment charges Parks Acct- May'13 29276 $ 553.37 Total $ 553.37 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 Voucher No. Warrant No. 146500 Indiana Dept. of Workforce Development Allowed 20 10 North Senate Ave., SE106 Indianapolis, IN 46204-2277 In Sum of$ $ 553.37 ON ACCOUNT OF APPROPRIATION FOR 101-General Fund PO#or INVOICE NO. ACCT#/ AMOUNT Board Members Dept# TITLE 29276 676277000 4110000 $ 553.37 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 20-Jun 2013 Signature $ 553.37 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund