HomeMy WebLinkAbout237535 09/23/14 �� CITY OF CARMEL, INDIANA VENDOR: 368692
ONE CIVIC SQUARE SRINIVAS SIRIPURAPS
;: 3. CHECK AMOUNT: $********91.00*
CARMEL, INDIANA 46032 12635 BRANDENBURG DR CHECK NUMBER: 237535
+y,�TON�°r CARMEL IN 46032 CHECK DATE: 09/23/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 91.00 REFUNDS AWARDS & INDE
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GLOBAL REFUND RECEIPT
Receipt# 1343655
ar `� r� Payment Date: 09/12/14
r s ecr a «rl Household#: 49676
Monon Community Center Srinivas Siripurapu Hm Ph: (812)962-5750
Carmel IN 46032 Fp"v
EP 1 6 2014 12635 Brandenburg Dr. Wk Ph: (317)709-8324
Carmel IN 46032 Cell Ph:(614)546-9876
slhari77 hotmail.com
Phone: (317)848-7275 _------ ______
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 91.00- 91.00 0.00
- - PREVIOUS NET CREDIT HOUSEHOLD BALANCE 91.00
Processed on 09/12/14 @ 15:21:06 by BJJ NEW REFUND AMOUNT(-) 91.00
TOTAL,REFUNDABLE AMOUNT 91;00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 91.00 Made By==>REFUND FINAN With Reference=_>1081-10-4358400 Cys
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued
jr1�-r
t zed Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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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.
Siripurapu, Srinivas Terms
12635 Brandenburg Dr. Date Due
Carmel, IN 46032
I
Invoice Invoice Description
Date Number ' (or note attached invoice(s) or bill(s)) Amount
9/12/14 1343655 Refund $ 91.00
Total $ 91.00
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.
Siripurapu, Srinivas Allowed 20
12635 Brandenburg Dr.
Carmel, IN 46032
Iln Sum of$
i
$ 91.00
i
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
I
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-10 1343655 4358400 $ 91.00 it 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
18-Sep 2014
Signature
$ 91.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund