250476 10/07/15 '..�,q*F• _ CITY OF CARMEL, INDIANA VENDOR: 369934
`` CHECK AMOUNT: $ 154.00"
® :, ONE CIVIC SQUARE YAN ZENG �""k��"
:._ ?� CARMEL, INDIANA 46032 3292 HOMESTRETCH DRIVE CHECK NUMBER: 250476
+.y,TON Lo; CARMEL IN 46032 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1458120 154.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1458120
arme I * C lay Payment Date: 09/30/15
Household #: 45916
Parks&Recreation
OCT 1 2015
Monon Community Center BY'—=_—�-- Yan Zeng Hm Ph: (317)973-5016
Carmel IN 46032 3292 Homestretch Dr. Wk Ph: (317)274-7719
Carmel IN 46032 Cell Ph:(317)366-2873
cm2725@hotmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 154.00- 154.00 0.00
i
PREVIOUS NET HOUSEHOLD BALANCE 154.00
Processed on 09/30/15 @ 10:21:06 by JAB NEW REFUND AMOUNT(-) 154.00
TOTAL REFUNDABLEAMOUNT" 154.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 154.00 Made By=_>REFUND NAN With Reference=_>parent request;81-10-4358400 refund
A ds are subject to Stat and of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Authorize Signature Dat Authorized Signature Date
Escape a Pa ses 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.
Zeng, Yan Terms
3292 Homestretch Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/30/15 1458120 Refund $ 154.00
Total $ 154.00
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.
Zeng, Yan Allowed 20
3292 Homestretch Dr
Carmel, IN 46032
In Sum of$
$ 154.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1081-10 1458120 4358400 $ 154.00 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
October 1, 2015
Signature
$ 154.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund