252022 12/02/15 CITY OF CARMEL, INDIANA VENDOR: 370101
ONE CIVIC SQUARE KATE JOHANSSON CHECK AMOUNT: $*******333.00*
CARMEL, INDIANA 46032 2258 IRISH ROSE LANE CHECK NUMBER: 252022
INDIANAPOLIS IN 46280 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 2000254003 333.00 REFUNDS AWARDS & INDE
11/17/2015 Receipt#2000254.003
Monon Community Center East Buildi C IV oI cher #2000254.003
1235 Central Park Dr. East NOV 2 4 2015 Nov 17, 2015 11:46 AM
Carmel, IN 46032 BY:
Phone: (314) 848-7275
FAX: - 19 -Mel @ clay
-
Email: info@carmelclayparks.com ;3
Parks& Recreation
KATE 30HANSSON NATIONAL
2258 IRISH ROSE LANE AND ACCREDITED AGENCY
INDIANAPOLIS, IN 46280
Prepared By: bennyj
Customer ID: 23602
Primary phone: (317) 374-8448, Secondary phone: (317) 956-1080
Check: ($333.00) Check #
Total Received: ($333.00) Total Refund: ($333.00)
Kate Johansson Refund balance Refund Each 1.00 $333.00 ($333.00)
2258 Irish Rose lane Action: Refund Balance balance
Indianapolis, IN 46280
Primary phone: (317) 374-
8443
Email:
kjohansson@sbcglobal.net
ID: 23602
Total Charges ($333.00)
Total Payments ($333.00)
Balance $0
0� INS I
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https:Hactivenet023.active.com/carmelclayparks/servlet/processReceiptPayment.sdi 1/1
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.
Johansson, Kate Terms
2258 Irish Rose Lane Date Due
.Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/17/15 2000254003 Refund $ 333.00
Total $ 333.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Johansson, Kate Allowed 20
2258 Irish Rose Lane
Indianapolis, IN 46280
In Sum of$
$ 333.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-4 2000254003 4358400 $ 333.00 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
November 25, 2015
pkk&W-4�
Signature
$ 333.00 Business Services Director
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund