HomeMy WebLinkAbout235148 07/22/14 NDIANA VENDOR: 368449
CITY OF CARMEL, I 1 ONE CIVIC SQUARE ARON LIU CHECK AMOUNT. S«}«««««234.00«
® O CARMEL, INDIANA 46032 11502 MCKENZIE PKWY CHECK NUMBER: 235148
+y _ CARMEL IN 46032 CHECK DATE: 07/22/14
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1301471 234.00 REFUNDS AWARDS & INDE
PASS REFUND RECEIPT
Receipt# 1301471
Payment Date: 07/11/14
.r 6 '�'STS Household#: 1033
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Pawe-cre, ton JUL 1 4 2014
BY___
Monon Community Center 2.on Liu Hm Ph: (317)569-0638
Carmel IN 46032 1-502 Mckenzie Pkwy Wk Ph: (317)491-3148
Carmel IN 46032 Cell Ph:
amelia_l@hotmail.com
,Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION -Refund Of 234.00
Pass Holder: Esther Liu Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: 20-Visit(ESE20V),#34191 26.00 0.00 26.00 0.00 0.00
Valid Dates: 08/15/2012 to 05/29/2014 (Pass Cancellation)
Cancellation Effective: 07/11/2014
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/11/14 @ 09:30:30 by BJJ FEES CHANGED ON CANCELLED ITEMS(+) 234.00-
NET-AMOUNT FROWCANCELLED ITEMS 234:00='
TOTAL AMOUNT'REFUNDED 23400-.
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 234.00 Made By==>REFUND FINAN With Reference=_>
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued
Auth ed Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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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.
Liu, Aron Terms
11502 McKenzie Pkwy Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/11/14 1301471 Refund $ 234.00
Total $ 234.00
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
I
Voucher No. Warrant No.
Liu,Aron Allowed 20
11502 McKenzie Pkwy
Carmel, IN. 46032
In,hum of$
I
$ 234.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
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i
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-6 1301471 4358400 $ 234.00 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
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f
I
18-Jul 2014
I�
Signature
$ 234.00 _I Accounts Payable Coordinator
Cost distribution ledger classification if Title
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claim paid motor vehicle highway fund