246575 06/17/15 ;1�u!.k±qyf CITY OF CARMEL, INDIANA VENDOR: 369481
`� CHECK AMOUNT: $*******126.00*
}• ONE CIVIC SQUARE CURT WARREN
s. +`; CARMEL, INDIANA 46032 2445 HOPWOOD DRIVE CHECK NUMBER: 246575
9,y„_ CARMEL IN 46032 CHECK DATE: 06/17/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 X25050120 126.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1450711
la Payment Date: 06/05/15
Nr
crd io n Household#: 16575
Monon Community Center Curt Warren Hm Ph: (317)733-2772
Carmel IN 46032FJUg 2015 2445 Hopwood Drive Wk Ph: (317)876-3636
Carmel IN 46032 Cell Ph:(317)910-6705
saranwarren@hotmail.com
Phone: (317)848-7275 _
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 126.00- 126.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 126.00
Processed on 06/05/15 @ 14:46:58 by BJJ NEW REFUND AMOUNT(-) 126.00
TOTAL'REFUNDABLE AMOUNT'_ 126.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 126.00 Made By==>REFUND FINAN With Reference=_>1081-10-4358400 G'� WD__,Jr
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issue .
t>d, nature 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.
Warren, Curt Terms
2445 Hopwood Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/5/15 1450711 Refund $ 126.00
Total $ 126.00
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
Voucher No. Warrant No.
Warren, Curt jAllowed 20
2445 Hopwood Drive
Carmel, IN 46032
In Sum of$
$ 126.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept#
1081-10 1450711 4358400 $ 126.00 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
i
June 12, 2015
'P7
I
I Signature
$ 126.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I