HomeMy WebLinkAbout245762 06/03/15 %� \� CITY OF CARMEL, INDIANA VENDOR: 369412
® 1 ONE CIVIC SQUARE NICOLE BOTIMER CHECK AMOUNT: $********52.00*
9 ,Q CARMEL, INDIANA 46032 5319 RIPPLING BROOK WAY CHECK NUMBER: 245762
.y��TON�' CARMEL IN 46033 CHECK DATE: 06/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1448272 52.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1448272
Car
l * Cl �_ Payment Date: 05/20/15
f' & E; fe' atidt1 [MAY
� � Household#: 5915
2 1 2015Monon Community CenterNicole Botimer Hm Ph: (317)810-9366
Carmel IN 46032 5319 Rippling Brook Way Wk Ph: (317)337-3104
Carmel IN 46033 Cell Ph:(317)910-8948
Phone: (317)848-7275 NBotimer@gmail.com
Fed Tax ID#35-6000972
Refund Details
Oria-Bal Refund New Bal
Module: Pass Management 52.00- 52.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 52.00
Processed on 05/20/15 @ 14:34:32 by BJJ NEW REFUND AMOUNT(-) 52.00
:.TOTAL REFUNDABLE AMOUNT' ,52.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 52.00 Made By==>REFUND FINAN With Reference==>1081-2-4358400
All refund are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Aut o' 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.
Bother, Nicole Terms
5319 Rippling Brook Way Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/20/15 1448272 Refund $ 52.00
Total $ 52.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with I C 5-11-10-1.6
Clerk-Treasurer
i
Voucher No. Warrant No.
Botimer, Nicole A lowed 20
5319 Rippling Brook Way
Carmel, IN 46033
In Sum of$
I
$ 52.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
Po#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1081-2 1448272 4358400 $ 52.00 I!hereby certify that the attached invoice(s), or
011(s)is(are)true and correct and that the
natenals or services itemized thereon for
I
which charge is made were ordered and
received except
May 28, 2015
Signature
$ 52.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I