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221367 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CARMEL, INDIANA 46032 DEVELOPMENT ATTN.ACCT RECV CHECK AMOUNT: $3,390.26 � 10 N SENATE AVE o„ CHECK NUMBER: 221367 INDIANAPOLIS IN 46204-2277 CHECK DATE: 7/2/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 101 5023990 133438 2 , 331 . 26 OTHER EXPENSES 1120 4110000 133438 1, 059 . 00 FULL TIME REGULAR 133438 -1 INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT BENEFIT ADMINISTRATION, 10 NORTH SENATE AVENUE, INDIANAPOLIS, IN 46204-2277 Toll 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 LOCATION NUMBER 133438 -000 ONE CIVIC SQ CARMEL IN 46032-2584 REPORTING MONTH MAY, 2013 NETCHARGES $1459 .00 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 alnv naYments Were , ade the .+..,t....... had the -a.. y a _ ��.�v�ci II Laic VN�lVf LUIIILY 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, A 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 *** R S LANNAN 04/26/14 REG 05/26/13 05/25/13 353.00 TOTAL NEW CHARGES FOR THE REPORTING MONTH 05/13 : 1,059.00 --------------- --------------- TOTAL AMOUNT OF NET CHARGES : 1,059.00 The following charge(s) are POTENTIAL credits to your account. A determination was made and you were found not liable for these charges. But because you have chosen to make payment in lieu of contributions for Unemployment Insurance, your account cannot be credited for these charges unless or until the claimant(s) refund the overpayment. Your account will be credited as the claimant .efunds the overpayment in full or in monthly installments. XXX-XX-8896 T N TEMPLE /� 05/22/10 REG 07/11/09 47.05 XXX-XX-8896 T N TEMPLE 05/22/10 REG 07/18/09 17.76 *** END OF BENEFIT CHARGE STATEMENT **** 3} 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 invoice(s) or bill(s)) PO# Amount 6/7/13 133438 Unemployment charges City Acct/Parks Dept May'13 $ 64.81 Total $ 64.81 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$ $ 64.81 ON ACCOUNT OF APPROPRIATION FOP. 101-General Fund PO#or INVOICE NO. ACCT#/ AMOUNT Board Members Dept# TITLE 276 438 411 00 $ 4.81 '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 1 i I Signature $ 64.81 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund Sheeks, Cindy L From: Snyder, Denise W Sent: Friday, June 28, 2013 5:47 PM To: Sheeks, Cindy L Subject: Re: DWD Clearance for City of Carmel C44P-3-3468 Ok just thought u might since it was workforce one. Just let me know if u need my help. Sent from my iPhone On Jun 28, 2013, at 5:18 PM, Sheeks, Cindy L <CSheeks @carmel.in.gov> wrote: No clue. Will have to check into it Monday. From: Snyder, Denise WSJ Sent: Friday, June 28, 2013 4:55 PM To: Sheeks, Cindy L Subject: Fwd: DWD Clearance for City of Carmel C44P-3-3466 Is this something you may know about? Sent from my iPhone V� Begin forwarded message: From. Korobkin, Beverly <BKorobkin @dwd.IN.gov> � „p(1 Date:June 28, 2013, 3:33:23 PM EDT 1 To: "Snyder, Denise W" <DSnyder @carmel.in.gov> Subject: RE: DWD Clearance for City of Carmel C44P-3-3468 Y. Good Afternoon.... V" I have researched the matter. The City of Carmel has an outstanding liability on their Unemployment Insurance account in the amount of$992.24. This is for the benefit charges that were due by May 31, 2013. Once these charges have been paid and th payment has posted to the account,the State Agency will need to resubmit the clearance request. V1 Please let me know if you have any additional questions. you, li Y V "� Bever) Thank ,Korobkin � t Supervisor Collection and Enforcement Unit Indiana Department of Workforce Development 317-232-7487 (� CN �� STATEMENT OF CONFIDENTIALITY: THE INFORMATION IN THIS MESSAGE IS PRIVILEGED AND CONFIDENTIAL AND IT IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY NAMED ABOVE. IF THE READER OF THIS MESSAGE IS NOT THE INTENDED 1 RECIPIENT, YOU ARE HEREBY NOTIFIED THAT YOU ARE PROHIBITED FROM DISSEMINATING, DISTRIBUTING, OR COPYING THE INFORMATION CONTAINED IN THIS MESSAGE. IF YOU HAVE RECEIVED THIS MESSAGE IN ERROR, PLEASE NOTIFY THE SENDER IMMEDIATELY AND DESTROY ALL COPIES OF THE ORIGINAL MESSAGE. From: Snyder, Denise W [mailto:DSnyder(j5)carmel.in.gov] Sent: Thursday, June 27, 2013 1:57 PM To: Korobkin, Beverly Subject: FW: DWD Clearance for City of Carmel C44P-3-3468 Good Afternoon, I received this email from one of my firefighters as he does not know what it is in regards to. I, myself have no idea what this is. Can you help us sort this out? What exactly is this and what is this for? Thank you in advance, � , __ Budget and Accredilation Manages` Carmel Fire Department 317-571-2600 317-571-2615 - Fax dsnyder@carmei.in..gc From: Tierney, Scott A Sent: Thursday, June 27, 2013 1:51 PM To: Snyder, Denise W; smcctierney(a frontier.com Subject: FW: DWD Clearance for City of Carmel C44P-3-3468 Denise, Do you know anything about this or who to contact? Tierney From: Fields, Mary [mafieldsCabdhs.IN.gov] Sent: Thursday, June 27, 2013 10:20 AM To: Tierney, Scott A Subject: FW: DWD Clearance for City of Carmel C44P-3-346B Scott, Per the email below the Dept. of Workforce Development shows that City of Carmel is not clear, which means that according to DWD's records, the contractor or grantee owes the State of Indiana money. You need to notify the contractor or grantee and ask them to contact the following person at DWD to,get this issue resolved: 2 i Beverly Korobkin _ 317 232-7487 bkorobkin dwd.in. ov DWD's policy is that they not permitted to share financial details about a particular employer with anyone but representatives of the employer, so they asked that DHS not call either of the contact folks. DWD also stressed that, when calling the contact folks, the caller must have the correct tax id number of the entity who has the problem. There is an online location where payments may be made http://www.in.gov/dwd/3657.htm, but there's a convenience fee, so payments also may be made by mail. DWD advised that it may take 2 weeks after the payment is received by mail for the clearance to appear in the computer. DWD stressed that notices of non-compliance always go to the financial person at an employer, so DHS project managers may want to stress to our grantee/sub- grantee and contracting partners that the person making the call to DWD should touch base with their financial person before making the call to DWD. Scott, the agreement cannot move forward through the signature process until this issue is resolved. Let me know if you have any questions. Mary Mary A. Fields Council Coordinator Indiana Department of Homeland Security 302 W. Washington Street, E 220 Indianapolis, IN 46204 317-234-6219 mafields @dhs.in.gov From: Wisthoff, Donna Sent: Thursday, June 20, 2013 4:31 PM To: Fields, Mary Cc: Gavin, Brad Subject: DWD Clearance for City of Carmel C44P-3-3468 Mary, it is for the City of Carmel. The above designated contract or grant was designated as NOT CLEAR by the Indiana Department of Workforce Development (DWD), which means that according to DWD's records, the contractor or grantee owes the State of Indiana money. You need to notify the contractor or grantee and ask them to contact one of the following two people at DWD to get this issue resolved: Beverly Korobkin (317) 232-7487 bkorobkin @dwd.in.goy DWD's policy is that they not permitted to share financial details about a particular employer with anyone but representatives of the employer, so they asked that DHS not 3 call either of the contact folks. DWD also stressed that, when calling the contact folks, the caller must have the correct tax id number of the entity who has the problem. There is an online location where payments may be made http://www.in.gov/dwd/3657.htm, but there's a convenience fee, so payments also may be made by mail. DWD advised that it may take 2 weeks after the payment is received by mail for the clearance to appear in the computer. DWD stressed that notices of non-compliance always go to the financial person at an employer, so DHS project managers may want to stress to our grantee/sub-grantee and contracting partners that the person making the call to DWD should touch base with their financial person before making the call to DWD. I 4 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 -� Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 5yd F POM WV 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 IN SUM OF $ Rao S l� L�babq $ ON ACCOUNT OF APPROPRIATION FOR 6 tit I Board Members PO#or DEPT# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or J. 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 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund