HomeMy WebLinkAbout247780 07/28/15 � CSN
"F� CITY OF CARMEL, INDIANA VENDOR: 369524
l ONE CIVIC SQUARE DEBBIE CALDWELL CHECK AMOUNT: S""""'173.00'
f' ;? CARMEL, INDIANA 46032 114858URKWOOD CHECK NUMBER: 247780
�.y.roH.�. CARMEL IN 46032 CHECK DATE: 07/28/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 1455924 173.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1455924
Cal-m"e l a Clay Payment Date: 07/16/15
a��1' Yro;.D Household #: 17116
Parks&Recreation
JUL 7 205
Monon Community Center
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
dibflip@yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 173.00- 173.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 173.00
Processed on 07/16/15 @ 10:22:19 by JAB NEW REFUND AMOUNT(-) 173.00
TOTAL REFUNDABLE AMOUNT 173.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 173.00 Made By==>REFUND FINAN With Reference==>parent request;82-10-4358400 refund
All reftyrrdre subject -State pard of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
I /
UDay
ature to Authorized Signature Date
Escaes 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.
Terms
Caldwell, Debbie
Date Due
11485 Burkwood
Carmel, IN 46033
Invoice Invoice Description
or note attached invoice(s) or bill(s)) Amount
Date Number ( $ 173.00
7/16115 1455924 Refund
Total $ 173.00
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with 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$
$ 173.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-10 1455924 4358400 $ 173.00 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
July 23, 2015
Signature
$ 173.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund