HomeMy WebLinkAbout232476 05/13/14 y1_CAq
a:% ;� CITY OF CARMEL, INDIANA VENDOR: 368208
.�3 ® , ONE CIVIC SQUARE MELODY COCKRUM
CHECK AMOUNT: $********90.00*
,� ?� CARMEL, INDIANA 46032 12838 HORSEFERRY ROAD CHECK NUMBER: 232476
°.y,�TON,.�` CARMEL IN 46032 CHECK DATE: 05/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1245678 90.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1245678
Payment Date: 05/05/14
. --=---- Household#: 20490
� t10 � �;�
ly 0 6 2014
Monon Community Center Melody Cockrum Hm Ph: (317)645-5345
Carmel IN 46032 -- 12838 Horseferry Rd. Wk Ph: (317)688-2061
Carmel IN 46032 Cell Ph:(317)645-5345
melcockrum@yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 90.00- 90.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 90.00
Processed on 05/05/14 @ 17:21:13 by BJJ NEW REFUND AMOUNT(-) 90.00
TOTAL REFUNDABLE"AMOUNT- 90.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 90.00 Made By==>REFUND FINAN With Reference=_>1081-10-4358400
All refunds re subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Au zed Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
L�
Page# 1 of 1
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.
Cockrum, Melody Terms
12838 Horseferry Rd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/5/14 1245678 Refund $ 90.00
Total $ 90.00
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
Voucher No. Warrant No.
Cockrum, Melody Allowed 20
12838 Horseferry Rd
Carmel, IN 46032
+ j In Sum of$
I
$ 90.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE.
PO#or INVOICE NO. ACCT#!TITLE AMOUNT Board Members
Dept#
1081-10 1245678 4358400 $ 90.00 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
I
8-May 2014
Signature
$ 90.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i