HomeMy WebLinkAbout242998 03/11/15 r Coq
��_ CITY OF CARMEL, INDIANA VENDOR: 369161
.ONE CIVIC SQUARE SAUNDRA KURKER CHECK AMOUNT: $*******1 15.00'
:q '�;��� CARMEL, INDIANA 46032 9976 GWIN DRIVE CHECK NUMBER: 242998
.y��TON Y-`' INDIANAPOLIS IN 46280 CHECK DATE: 03/11/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 115.00 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt# 1413061 r1 °. Clay
Payment Date: 02/25/2015
Household#: 4634 Parks& 'dorTe0b n
Home Phone: (317)566-9183
FEB 2 6 2015
SAUNDRA KURKER � Monon Community Center
9976 GWIN DR. Carmel IN 46032
INDIANAPOLIS IN 46280
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION -Refund Of 115.00
Pass Holder: Saundra KUrker Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: XMC Senr Annual (XM MCSA),#249898 161.00 0.00 161.00 0.00 0.00
Valid Dates: 07/17/2014 to 07/17/2015 (Pass Cancellation)
Cancellation Effective: 02/25/2015
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
nAnnual MC Pass 161.00 1.00 0.00 0.00 161.00
Cancel Reason: Guest request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 02/25/15 @ 06:22:03 by DMLEONARD FEES CHANGED ON CANCELLED ITEMS(+) 115.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES(-) 0.00
SALES TAX CHARGED ON CANCELLED FEES(+) 0.00
NET AMOUNT FROM CANCELLED ITEMS' 115.00-
-TOTAL.AMOUNT REFUNDED' ,115.00
NEW NET HOUSEHOLD BALANCE 0.00-
Refund;of=_> 115.00 Made By==>REFUND FINAN With Reference==>
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Authorized Sig t 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.
Kurker, Saundra Terms
9976 Gwin Dr Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/25/15 1413061 Refund $ 115.00
Total $ 115.00
I 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
.i
Voucher No. Warrant No.
Kurker, Saundra Allowed 20
9976 Gwin Dr
Indianapolis, IN 46280
In Sum of$
$ 115.00
1
ON ACCOUNT OF APPROPRIATION FOR
i
109 -MCC
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1092 1413061 4358400 $ 115.00 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
iwhich charge is made were ordered and
received except
I
March 5, 2015
'P
I
Signature
$ 115.00 I Accounts Payable Coordinator
Cost distribution ledger classification if i Title
claim paid motor vehicle highway fund
i