HomeMy WebLinkAbout237806 10/08/14 r Coq
'• CITY OF CARMEL, INDIANA VENDOR: 368712
it ONE CIVIC SQUARE CHRISTIE CLEM CHECK AMOUNT: $*******224.00*
CARMEL, INDIANA 46032 1576 W 96TH ST CHECK NUMBER: 237806
INDIANAPOLIS IN 46260 CHECK DATE: 10/08/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1349793 224.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1349793
Carmel
v Payment Date: 09/26/14
Household#: 55347
Nrks&Re.creation
Monon Community Center Christie Clem
Carmel IN 46032 1576 W 96th St. Wk Ph: (317)651-4218
Indianapolis IN 46260 Cell Ph:(317)730-3659
caf223@hotmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 224.00- 224.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 224.00
Processed on 09/26/14 @ 10:11:07 by BJJ NEW REFUND AMOUNT(-) 224.00
TOTAL.REFUNDABLE AMOUNT :'iµ224.00°
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 224.00 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 J
r
ut Priied Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
PH
SEP 26 2014
Y:
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.
Clem, Christie Terms
1576 W 96th St Date Due
Indianapolis, IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) Amount
9/26/14 1349793 Refund $ 224.00
Total $ 224.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with I C 5-11-10-1.6
20_
Clerk-Treasurer
Voucher No. Warrant No.
I
Clem, Christie Allowed 20
1576 W 96th St
Indianapolis, IN 46260.
In Sum of$
$ 224.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITLE AMOUNT
1081-9 1349793 4358400 $ 224.00 (''.hereby certify that the attached invoice(s), or
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
i
which charge is made were ordered and
'received except
I
2-Oct 2014
i
JSignature
$ 224.00 ! Accounts Payable Coordinator
Cost distribution ledger classification if + Title
claim paid motor vehicle highway fund
i
� I