HomeMy WebLinkAbout238602 10/28/14 CITY OF CARMEL, INDIANA VENDOR: 368802
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g® '.J• ONE CIVIC SQUARE STEFANIE FARLEY CHECK AMOUNT: $*******139.00*
CARMEL, INDIANA 46032 15815 FALCON FIRE DRIVE CHECK NUMBER: 238602
WESTFIELD IN 46074 CHECK DATE: 10/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1358478 139.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1358478
r iar" , a ClayPayment Date: 10/17/14
Household#: 47929
Parks&Recreation
I�EC �r �
Monon Community Center 0CT 212 014 Stefanie Farley Hm Ph: (317)460-8301
Carmel IN 46032 15815 Falcon Fire Drive
Westfield IN 46074 Cell Ph:
RV. stefaniespurlin@yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 139.00- 139.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 139.00
Processed on 10/17/14 @ 13:48:50 by LVA NEW REFUND AMOUNT(-) 139.00
TOTAL REFUNDABLE AMOUNT 139.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 139.00 Made By==>REFUND FINAN With Reference==>advanced request
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issue .
Authorized Signatu,KeeDae d 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.
Farley, Stefanie Terms
15815 Falcon Fire Drive Date Due
Westfield, IN 46074
Invoice Invoice Description .
Date Number (or note attached invoice(s) or bill(s)) Amount
10)17/14 1358478 Refund $ 139.00
i
Total $ 139.00
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.
Farley, Stefanie Allowed 20
15815 Falcon Fire Drive
Westfield, IN 46074
In Sum of$
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$ 139.00
ON ACCOUNT OF APPROPRIATION FOR
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109 -MCC
Po#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT 5
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1096-32 1358478 4358400 $ 139.00 ( I 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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23-Oct 2014
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signature
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$
� Accounts Payable able Coordinator Y
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund