HomeMy WebLinkAbout248059 07/28/15 CITY OF CARMEL, INDIANA VENDOR: 369669
b it ONE CIVIC SQUARE KAROL TIERNEY CHECK AMOUNT: S"'"""'108.00"
t ;?� CARMEL, INDIANA 46032 13528 LABLANCA BEND CHECK NUMBER: 248059
WESTFIELD IN 46074 CHECK DATE: 07/28/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 108.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1454789
a r m e l a Clay ay Payment Date: 07/13/15
Parks&Recreation Household #: 10880
1 �` g�7T D
JUL 1 4 2015
Monon Community Center Karol Tierney Hm Ph: (317)733-9643
Carmel IN 46032 $ '� 13528 Lablanca Bend Wk Ph: (317)583-7626
Westfield IN 46074 Cell Ph:
jtierney@indy.rr.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 108.00- 108.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 108.00
Processed on 07/13/15 @ 08:45:33 by JAB NEW REFUND AMOUNT(-) 108.00
TOTAL REFUNDABLE AMOUNT 108.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 108.00 Made By—REFUND FINAN With Reference=_>parent request;81-3-4358400 refund
All rgfufld.5 are subje �State ard of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
iss ed.
Author ed Si ature Datd 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.
Tierney, Karol Terms
13528 Lablanca Bend Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/13/15 1454789 Refund $ 108.00
Total $ 108.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Tierney, Karol Allowed 20
13528 Lablanca Bend
Westfield, IN 46074
In Sum of$
$ 108.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1081-3 1454789 4358400 $ 108.00 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
1pkmbtyu�
Signature
$ 108.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund