HomeMy WebLinkAbout239059 11/11/14 CITY OF CARMEL, INDIANA VENDOR: 368837
ONE CIVIC SQUARE REBECCA KANACH CHECK AMOUNT: $*******412.50*
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CARMEL, INDIANA 46032 12877 BRIGHTON CIRCLE CHECK NUMBER: 239059
CARMEL IN 46032 CHECK DATE: 11/11/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1362247 412.50 REFUNDS AWARDS & INDE
PASS REFUND RECEIPT
y Receipt# '1362247
Date: 11/05/14
Household#: 5576
Par ks,Aecreation
T-1 7
FRE ��Monon Community Center v 0 � 2014 Rebecca Kanach Hm Ph: (317)815-4959
Carmel IN 46032 12877 Brighton Circle Wk Ph: (317)273-1700
Carmel IN 46032 Cell Ph:(317)679-8178
rkanach@msn.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION -Refund Of 200.00
Pass Holder: Karinna Kanach Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: 20-Visit(ESE20V),#43228 50.00 0.00 50.00 0.00 0.00
Valid Dates: 08/11/2009 to 05/27/2013 (Pass Cancellation)
Cancellation Effective: ,11/05/20111 _ - -- — - - -
Cancel Reason: no longer need ese
CANCELLATION -Refund Of 212.50
Pass Holder: Isabelle Kanach Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: 20-Visit(ESE20V),#34273 37.50 0.00 37.50 0.00 0.00
Valid Dates: 08/11/2009 to 05/27/2013 (Pass Cancellation)
Cancellation Effective: 11/05/2014
Cancel Reason: r=needese
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 11/05/14 @ 13:45:28 by BJJ FEES CHANGED ON CANCELLED ITEMS(+) 412.50-
NET,AMOUNT FROM CANCELLED'ITEMS= ",,,,'412.50-
TOTAL AMOUNT:REFUNDED
°412.50TOTAL'=AMOUNT:REFUNDED
NEW NET HOUSEHOLD BALANCE 0.00
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Refund of 412.50 Made By ND RE INAN With Reference
F U
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 Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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.
Kanach, Rebecca Terms
12877 Brighton Circle Date Due
Carmel, IN 46032
W
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/14 1362247 Refund $ 412.50
Total $ 412.50
1 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
Voucher No. Warrant No.
Kanach, Rebecca All 20
12877 Brighton Circle
Carmel, IN 46032
In iSum of$
i
$ 412.50
i
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept# j
1081-10 1362247 4358400 $ 412.50 1 hereby certify that the attached invoice(s), or
bili(s)is(are)true and correct and that the
materials or services itemized thereon for
wlidch charge is made were ordered and
received except
I
i
n
6-Nov 2014
i
i
Signature
$ 412.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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