HomeMy WebLinkAbout233949 06/25/14 CITY OF CARMEL, INDIANA VENDOR: 364253
ONE CIVIC SQUARE SCOTT ADAMS CHECK AMOUNT: $***'*'*637.00*
CARMEL, INDIANA 46032 5364 WOODFIELD DR N CHECK NUMBER: 233949
9�iTON CARMEL IN 46033 CHECK DATE: 06/25/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 637.00 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt# 1271565
Carmoll Cla Payment Date: 06/13/14
Household#: 24955
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JUN 16 2014
Monon Community Center Scott Adams Hm Ph: (317)569-6013
Carmel IN 46032 i 5364 Woodfield Dr N Wk Ph: (317)815-6670
---- __- --- Carmel IN 46033 Cell Ph:(317)697-4524
coolcreek@sbcglobal.net
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 637.00- 637.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 637.00
Processed on 06/13/14 @ 10:06:37 by BJJ NEW REFUND AMOUNT(-) 637.00
TOTAL REFUNDABLE AMOUNT 637.00':
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 637.00 Made By=_>REFUND FINAN With Reference==>1082-13-4358400
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to pro ess. No cash refunds will be
issued.
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Auth ' d Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
q3,SW'
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.
Adams, Scott Terms
5364 Woodfield Dr N Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/13/14 1271565 Refund $ 637.00
Total $ 637.00
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
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Voucher No. Warrant No.
Adams, Scott Allowed 20
5364 Woodfield Dr N �.
Carmel, IN 46033
In Sum of
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$ 637.00
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ON ACCOUNT OF APPROPRIATION FOR
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108 -ESE
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITLE AMOUNT
1082-13 1271565 4358400 $ 637.00 I;1 hereby certify that the attached invoice(s), or
bill(s)js(are)true and correct and that the
materials or services itemized thereon for
fwhich charge is made were ordered and
i. received except
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19-Jun 2014
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Signature
$ 637.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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