HomeMy WebLinkAbout242186 2/17/2015 'f. . CITY OF CARMEL, INDIANA VENDOR: 369106
+il•. ONE CIVIC SQUARE PAVAN ADDEPALLE CHECK AMOUNT: $****"***45.00*
CARMEL, INDIANA 46032 12515 TIMBER CREEK DR-APT 3 CHECK NUMBER: 242186
CARMEL IN 46032 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1403907 45.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1403907
Carmel ,ala- y Payment Date: 02/09/15
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Parks&Recreation Household #: 45819
Smoky Row Elementary Pavan Addepalle Hm Ph: (317)660-6415
900 West 136th Street 12515 Timber Creek Dr Wk Ph: (317)249-5647
Carmel IN 46032 Apt 3 Cell Ph:(317)409-4595
Carmel IN 46032
Phone: (317)848-7275 pavan.addepalle@me.com
Fed Tax ID#35-6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 45.00- 45.00 0.00
I
PREVIOUS NET HOUSEHOLD BALANCE 45.00
Processed on 02/09/15 @ 17:55:30 by LKW NEW REFUND AMOUNT(-) 45.00
TOTAL REFUNDABLE AMOUNT 45.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 45.00 Made By==>REFUND FINAN With Reference==> V L � l 4 �� ]( L 00
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be 1 VV G1
ssue`'d.
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,Authorized Si nature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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LFE1 11 2015
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.
Addepalle, Pavan Terms
12515 Timber Creek Dr Apt 3 Date Due
Carmel, I N 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/9/15 1403907 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
120
Clerk-Treasurer
Voucher No. Warrant No.
Addepalle, Pavan Allowed 20
12515 Timber Creek Dr Apt 3
Carmel, IN 46032
In Sum of$
$ 45.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-8 1403907 4358400 $ 45.00 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
i
Signature
$ 45.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund