HomeMy WebLinkAbout240434 12/16/14 ! � CITY OF CARMEL, INDIANA VENDOR: 368966
i ONE CIVIC SQUARE WILLIAM SEIBERT CHECK AMOUNT: $********45.00*
9 ,_�; CARMEL, INDIANA 46032 10188 N COLLEGE AVE CHECK NUMBER: 240434
MUTON�, INDIANAPOLIS IN 46280 CHECK DATE: 12/16/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1374716 45.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# _ 1374716
Carmel * la Payment Date: 12/08/14
Park I�
� ecreation Household#: 51318
Monon Community Center William Seibert Hm Ph: (317)507-8326
Carmel IN 46032 10188 N. College Ave
indianapolis IN 46280 Cell Ph:(317)507-8326
Phone: (317)848-7275 kseibert@adultandchild.org
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Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 45.00- 45.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 45.00
Processed on 12/08/14 @ 13:59:57 by JAB NEW REFUND AMOUNT(-) 45.00
TOTAL REFUNDABLE AMOUNT 45.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 45.00 Made By==>REFUND FINAN Witheference==>81-6-4358400 refund;parent request
nds are subject to State Board of Accounts procedures and may to - ss. No cash refunds will be
I �!sued.
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A thorized 'gnature Date Authorized Signature Date
Escape Passes are non-refundable.
FDEC -9 2014
BX:
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.
Seibert, William Terms
10188 N College Ave. Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/8/14 1374716 Refund $ 45:00
Total $ 45.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20_
Clerk-Treasurer
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Voucher No. Warrant No.
Seibert, William �I Allowed
20
10188 N College Ave.
Indianapolis, IN 46280
S,In Sum of$
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$ 45.00
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ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
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PO#or INVOICE NO. ACCT#/TITLE AMOUNT ' Board Members
Dept#
1081-6 1374716 4358400 - $ 45.00 ( 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
i, received except
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12-Dec 2014
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Signature
$ 45.00 Accounts Payable Coordinator _
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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