246728 06/30/15 4 �.Cgq�f(
CITY OF CARMEL, INDIANA VENDOR: 369524
{; ® ONE CIVIC SQUARE DEBBIE CALDWELL CHECK AMOUNT: $*******346.00*
s %Q CARMEL, INDIANA 46032 11485 BURKWOOD CHECK NUMBER: 246728
9�_.,_1�r. CARMEL IN 46032 CHECK DATE: 06/30/15
ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 1453403 346.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1453403
Carmel I ' Payment Date: 06/19/15
Household#: 17116
14k Recreation
�r -v
Monon Community CenterJUN 2015 Debbie Caldwell Hm Ph: 317)848.6169
Carmel IN 46032 11485 Burkwood Wk Ph: 317)805 5059
Carmel IN 46033 Cell Ph:(317)690-7276
BY. _ dibflip@yahoo.com
Phone: (317)848-7275 -- _--
Fed Tax ID#35-6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 346.00- 346.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 346.00
Processed on 06/19/15 @ 13:19:47 by BJJ NEW REFUND AMOUNT(-) 346.00
TOTAL REFUNDABLE AMOUNT 346.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 346.00 Made By==>REFUND FINAN With Reference=_>1082-10-4358400
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
iss
Autho' 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.
Caldwell, Debbie Terms
11485 Burkwood Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/11115 1453403 Refund $ 346.00
Total $ 346.00
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.
Caldwell, Debbie Allowed 20
11485 Burkwood
Carmel, IN 46033
In Sum of$
� I
$ 346.00
i
i
ON ACCOUNT OF APPROPRIATION FOR
l
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT ' Board Members
Dept#
1082-10 1453403 4358400 . $ 346.00 lihereby 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
r
I
June 25, 2015
Signature
$ 346.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund