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HomeMy WebLinkAbout228029 1 /14/2014 CITY OF CARMEL, INDIANA VENDOR: 129401 Page 1 of 1 ONE CIVIC SQUARE MICHAEL HOLLIBAUGH CHECK AMOUNT: $125.97 CARMEL, INDIANA 46032 CARMEL IN 46032 2280 CHECK NUMBER: 228029 CHECK DATE: 1/14/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4355300 125 . 97 ORGANIZATION & MEMBER 12/17/13ff. Welcome to Indiana Licensing �;h..QpIndiahA �' _`} _: �.•) .. _ +.(j.} '"f..�•S:.s law "',"7r.:.; t"1'...... On&?e Licensing twp.,, pati;'-`w'�'.,.r•. 777 Payment Receipt This page serves as your receipt for this transaction. Your payment will appear on your credit card statement as "State of Indiana License Fee" or something similiar. To maintain this page for your records, you may print this page by clicking the "Print Receipt" button below. What to do next? Renewal Check back on the MyLicense site in 24 - 48 hours to see if your expiration d to was extended. If not, this may mean there is a problem with your renewal application and you will be contacted. o If you answered "Yes" to any of the disciplinary questions, you must provide additional information before your renewal can be processed. You may still work with your current license for up to 90 days while your renewal is being reviewed by the board. e When your license was issued or last renewed, you received a permanent license card one will not be generated from this renewal (except for CSR). Duplicate or replacement license cards can be purchased by returning to the licensing home page. Payment received - thank you. Licensee: Michael P. Hollibaugh License Number: LA29300015 Authorization Code: 08141Z Received Date: 12/17/2013 8:09:40 AM Transaction ID: 12248191 Credit Card Number: XXXX XXXX XXXX Fee Amount: $120.00 Enhanced Fee: $2.50 Instant Fee: $3.47 Total Payment: $125.97 ,-P rint,�Receipt•,i Renew Another License Logout https-.t[nVicense.in.goVegov/PaymentResult.asp)Oansvoer=processed&credit_card_number=3677&license_id=437200&process=REN&instant fee=3.47&fee a... 1/2 I 12/17/13 Welcome to Indiana Licensing W, EK" a' ;'Mc "01 im' -1`4- 571-39 O IcensIng nfine L ' Renewal Checklist MyUcense Onfine Renewahqs • Your Landscape Architect license expires on 12/31/2013. If your license expired prior to 2013, then you must contact our office for a renewal form and can not renew here. Licensing Home Page * The total fee for this renewal is $125.97 ($120.00 Renewal Fee + $5.97 in Logout processing fees.) • An additional $50.00 late fee will be applied to renewals after the deadline. • An individual who continues to practice with an expired license may be subject to disciplinary action. • Continuing Education:For questions regarding CE Requirements, please visit our Continuing Education Requirements page. a If you have any questions about your renewal, please contact us by email at pialOOpla.in.gov. htLpslimyiicense.in.go\degoVProcessStart.asp)Oprocess=REN&agency_id=l&license—id=437200&profession—id=31&licenseL_tMD--_id=179&LicenseNc>=LA2930... 1/1 i 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)) 12/17/13 Landscape Architect Dues $125.97 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. ALLOWED 20 Michael Hollibaugh IN SUM OF $ c/o One Civic Square Carmel, IN 46032 $125.97 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members Prior Year I hereby certify that the attached invoice(s), or 1192 I 43-553.00 $125.97 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, January 09, 2014 Directo Title Cost distribution ledger classification if claim paid motor vehicle highway fund