249219 09/09/15 CITY OF CARMEL, INDIANA VENDOR: 369808
4 i1 ONE CIVIC SQUARE JANICE COX CHECK AMOUNT: $**.....192.00*
CARMEL, INDIANA 46032 12462 SPRINGBROOKE RUN CHECK NUMBER: 249219
9' ? CARMEL IN 46033
CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 192.00 REFUNDS AWARDS & INDE
Receipt#2000063.003 Page 1 of 1
7S-Elp
Monon Community Center East Voucher #2000063.003
Building Sep 1, 2015 12:58 PM
1235 Central Park Dr. East
Carmel, IN 46032
Phone: (314) 848-7275
FAX: - Carinnel 0 Clay
-
Email: info@carmelclayparks.com arks m creI
on
NATIONAL GOLD MEDAL WINNER
JANICE COX AND ACCREDITED AGENCY
12462 SPRINGBROOKE RUN
CARMEL, IN 46033
Prepared By: jenniferb
Customer ID: 26098
Primary phone: (317) 993-7361, Secondary phone: (317) 581-9736
Refund Summary
Check: ($192.00) Check #
Total Received: ($192.00) Total Refund: ($192.00)
Transactions
Customer Description Item Unit Qty Fee Charge
Janice Cox Refund balance Refund Each 1.00 $192.00 ($192.00)
12462 Springbrooke Run Action: Refund Balance balance
Carmel,IN 46033
Primary phone:(317)993-
7361
Email:janicerwalker@aol.com
ID:26098
Total Charges ($192.00)
Total Payments ($192.00)
Balance $0
V
V
https:Hactivenet023.active.com/carmelclayparks/seivlet/processReceiptPayment.sdi 9/1/2015
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.
Cox, Janice Terms
12462 Springbrooke Run Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/1/15 2000063003 Refund $ 192.00
Total $ 192.00
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.
Cox, Janice
Allowed 20
12462 Springbrooke Run
Carmel, IN 46033 In Sum of$
$ 192.00 —
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
Board Members
PO#or INVOICE NO. ACCT#/TITL AMOUNT
Dept# ,
$ 192.00 1 hereby certify that the attached invoice(s), or
1081-11 2000063003 4358400
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
September 4, 2015
Signature
$ 192.00 Accounts Payable Coordinator
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund