242184 02/17/15 CITY OF CARMEL, INDIANA VENDOR: 369118
ONE CIVIC SQUARE TRENT ADAM CHECK AMOUNT: $'*******70.00'
s, r CARMEL, INDIANA 46032 5710 AQUAMARINE DRIVE CHECK NUMBER: 242184
CARMEL IN 46033 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 70.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1402041
Carmel #ay Payment Date: 02/05/15
J Household#: 61078
r�-ks&Rccrcati:an
Monon Community Center j FEB 1 1 2015 Adam Trent Hm Ph: (765)273-0191
Carmel IN 46032 5710 Aquamarine Drive
I Carmel IN 46033 Cell Ph:
(r=�` thetrentfamily@gmail.com
Phone: (317)848-7275 --
Fed Tax ID#35-6000972
Refund Details
Orio Bal Refund Nevy Bal
Module: Pass Management 70.00- 70.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 70.00
Processed on 02/05/15 @ 12:26:53 by BJJ NEW REFUND AMOUNT(-) 70.00
TOTAL REFUNDABLE AMOUNT 70400
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 70.00 Made By==>REFUND FINAN With Reference=_> !req:�u�,,t
All refunds are subject to State Board of Accounts procedure ay take 4-6 weeks to.process. No cash refunds will be
issue
LAu rized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
60
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.
Trent, Adam Terms
5710 Aquamarine Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/5/15 1402041 Refund $ 70.00
Total $ 70.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Trent, Adam Allowed 20
5710 Aquamarine Drive
Carmel, IN 46033
Ih Sum of$
$ 70.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-5 1402041 4358400 $ 70.00 1 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
February 12, 2015
Signature
$ 70.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund