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Home My WebLink About227896 1/14/2014 s F CITY OF CARMEL, INDIANA VENDOR: 146500 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF WORKFORCE CHECK AMOUNT: $571.36 CARMEL, INDIANA 46032 DEVELOPMENT ATTN:ACCT RECV oX,�o 10 N SENATE AVE CHECK NUMBER: 227896 INDIANAPOLIS IN 46204-2277 CHECK DATE: 1/14/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 101 5023990 133438-00 - . 59 OTHER EXPENSES 1120 4110000 133438-00 353 . 00 FULL TIME REGULAR 1125 4110000 133438-00 -5 . 29 FULL TIME REGULAR 1192 4110000 133438-00 186 . 00 FULL TIME REGULAR 1207 4111000 133438-00 58 . 38 PART-TIME 1301 4110000 133438-00 -20 . 14 FULL TIME REGULAR •' -"R-!r;'RR"il1L- -IIV I- - - - - - - - - - - - - - - - - - - - - The - - - - -The following items apply to your benefit ACCOUNT NUMBER: 133438 charges posted in NOVEMBER of 2010 ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL LIABILITY FOR THE PERIOD ....................................... ........................................ ....................................... PREVIOUS BALANCE 00 .00 .00 -ASSESSMENT OF BENEFIT CHARGES 20.14 -REVERSAL OF BENEFIT CHARGES 40.28CR -PAYMENT ADJUSTMENTS 20.14 .00 .00 ....................................... ENDING BALANCE .00 .00 .00 .00 The following items apply to your benefit ACCOUNT NUMBER: 133438 charges posted in MAY of 2011 ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL LIABILITY FOR THE PERIOD PREVIOUS BALANCE 00 00 .00 -ASSESSMENT OF BENEFIT CHARGES 5.29' "-REVERSAL OF BENEF'177-CHARGES 1U.58ER -PAYMENT ADJUSTMENTS 5.29 .06 .53 -ADJUSTMENT OF INTEREST/PENALTY .06CR .53CR ...............................:..:.... ENDING BALANCE .00 .00 .00 .00 THE TOTAL LIABILITY BALANCE IS LOCATED ON THE LAST PAGE OF THIS BILL. ******* ***** ** Additional interest will accrue at a rate of 1% per month and a one time penalty of 10% will be assessed on any outstanding benefit charges after the payment due date. If the liability is not paid in full, the Director may file with the clerk of the circuit court in your county, a warrant directing the sheriff to levy upon assets, in sufficient quantity to satisfy the amount of the warrant plus damages in the amount of 10%, plus penalties and interest. If you have any questions, please call (800) 891-6499 or (317) 232-7395 and ask for Collections. The following items apply to your benefit charges posted in MARCH of 2013 1 ACCOUNT NUMBER: 133438 ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL LIABILITY FOR THE PERIOD ....................................... ........................................ ....................................... ........................................ PREVIOUS BALANCE .00 .00 .00 -ASSESSMENT OF BENEFIT CHARGES 5.62 REVERSAL OF BENEFIT CHARGES 11.24CR -PAYMENT ADJUSTMENTS 5.62 .00 .00 ENDING BALANCE .00 .00 .00 .00 The following items apply to your benefit ACCOUNT NUMBER: 133438 charges posted in NOVEMBER of 2013 ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL LIABILITY FOR THE PERIOD ....................................... ........................................ ....................................... ....................................... PREVIOUS BALANCE 1,352.70 .00 .00 PAYMENTS 1 321.06CR 00 .00 ADJUSTMENTS-PAYMENT UST E MENTS 31.64CR .00 OG ENDING BALANCE .00 i .00 i 00 .00 THE TOTAL LIABILITY•BALANCE IS LOCATED ON THE LAST PAGE OF THIS BILL. ***************** Additional.interest will accrue at a rate of 1% per month and a one time penalty of 10% will be assessed on.any outstanding benefit charges after the payment due date. If the liability.is not paid in full, the Director may file with the clerk of the circuit court in your county, a warrant directing the sheriff to levy upon assets, in sufficient quantity to satisfy the amount of the warrant plus damages in the amount of 10%, plus penalties and interest. If you have any questions, please call (800) 891-6499 or (317) 232-7395 and ask for Collections. REIMBURSABLE BILL ACCOUNT NUMBER: 133438 PAGE: 3 OF 3 DATE: JANUARY 01 , 2014 The following items apply to your benefit charges posted in DECEMBER of 2013 ACCOUNT NUMBER: 133438 ACTIVITY SUMMARY BENEFIT CHARGES INTEREST PENALTY TOTAL LIABILITY FOR THE PERIOD PREVIOUS BALANCE .00 .00 .00 ASSESSMENT OF BENEFIT CHARGES 1,206.00 -REVERSAL OF BENEFIT CHARGES 603.000R -PAYMENTS 31.64CR .00 .00 ENDING BALANCE 571.36 .00 .00 571.36 THIS IS YOUR TOTAL LIABILITY. PAYMENTS MAILED AFTER THE 20TH OF THE MONTH MAY NOT BE REFLECTED ON THIS BILL. PLEASE $571. 36 PAY THIS AMOUNT NO LATER THAN..........JANUARY 31, 2014 Additional interest-will accrue at a rate of 1% per month and a one time penalty of 10% will be assessed on any outstanding benefit charges after the payment due date. If the liability is not paid in full, the Director may file with the clerk of the circuit court in your county, a warrant directing the sheriff to levy upon assets, in sufficient quantity to satisfy the amount of the warrant plus damages in the amount of 10%, plus penalties and interest. If you have any questions, please call (800) 891-6499 or (317) 232-7395 and ask for Collections. 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 REPORTING MONTH NOV, 2013 CARMEL IN 46032-2584 NETCHARGES $571, 95 POSTING DATE DEC-05, 2013 The receipt of this statement (Form 535) does not reopen the question of the claimant's eligibility for unempioyment_insLjran ce-since, before-any-pa,meats-wert--rade the eanployer. ha-d-the 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 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 REP ��NG MONTH 11/13 *** M D CALVERT 12/28/13 REG 11/29/13 11/23/13 64.00 --------------- TOTAL NEW CHARGES FOR THE REPORTING MONTH 11/13 : 603.00 *** REVERSED CHARGES/CREDITS FOR THE PRIOR MONTH 02/13 *** D R WILLIAMS 05/18/13 REG 11/13/13 02/02/13 5.62CR TOTAL REVERSOCHARGES/CREDIT FOR THE PRIOR MONTH 02/13 : 5.62CR *** REVERSED CHARGES/CREDITS FOR THE PRIOR MONTH 04/11 *** K L NEFOUSE 02/11/12 REG 11/14/13 04/02/11 5.29CR --------------- TOTAL REVERSED CHARGES/CREDIT FOR THE PRIOR MONTH 04/11 : 5.29CR *** REVERSED CHARGES/CREDITS FOR THE PRIOR MONTH 10/10 *** D A HUGHES08/20/11 REG 11/05/13 09/25/10 --------20.14CR TOTAL REVERSED CHARGES/CREDIT FOR THE PRIOR MONTH 10/10 : 20.14CR TOTAL AMOUNT OF NET CHARGES : 571.95 *** 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: NOVEMBER, 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 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 refunds-the overpayment in full or in monthly installments. D R WILLIAMS 05/18/13 REG / 1 V 02/02/13 61.02 *** END OF BENEFIT CHARGE STATEMENT **** An (*) in the ACQ column denotes a charge resulting from an acquisition of another business. VOUCHER NO. WARRANT NO. ALLOWED 20 IN Department of Workforce Development - Benefit Administration IN SUM OF $ 10 North Senate Avenue Indianapolis, IN 46204-2277 $64.00 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1207 I 133438- I 41-110.00 I $64.00 1 hereby certify that the attached invoice(s), or nnnno��z 112/u lV v 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 �2u� Thursday, December 19, 2013 tV ` Director, Brookshire Go Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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 Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12/05/13 1133438-OOODec13l Unemployment I $64.00 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