247913 07/28/15 �,C4A .
`' CITY OF CARMEL, INDIANA VENDOR: 364045
G: �
® '' ONE CIVIC SQUARE INDER JARIAL CHECK AMOUNT: $*—....173.00"
CARMEL, INDIANA 46032 615 WILLOWICK ROAD CHECK NUMBER: 247913
<oN`o, CARMEL IN 46032 CHECK DATE: 07/28/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 173.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1455873
Payment Payment Date: 07/15/15
Clay %'.T 7ED Household #: 14584
Parks Aecreatoo�n
JUL 1 7 2015
Monon Community Center LBY., Inder Jarial Hm Ph: (317)566-8321
Carmel IN 46032 '----615 Willowick Rd.
Carmel IN 46032 Cell Ph:
nancyjarial@sbcglobal.net
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 07/15/15 @ 12:50:14 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;82-12-4358400 refund
All ref s a sub' ate Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issu d. I
Au orized Signa ure I ate Authorized Signature Date
Escape ay 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.
Jarial, Inder Terms
615 Wllowick Rd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/15/15 1455873 Refund $ 173.00
Total $ 173.00
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.
Jarial, Inder Allowed 20
615 Willowick Rd
Carmel, IN 46032
In Sum of$
$ 173.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-12 1455873 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