252036 12/02/15 y .�4gMf. CITY OF CARMEL, INDIANA VENDOR: 370088
(i4.
6 i1 ONE CIVIC SQUARE PREDRAG KRSTIC CHECK AMOUNT: $ ......45.00`
i., s° CARMEL, INDIANA 46032 13500 CLIFTY FALLS DR CHECK NUMBER: 252036
*r:o�e� CARMEL IN 46032 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 45.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Carmel
I�i� -
Payment
1458446
RECEIVED Pa ment Date: 352 6/15
I�'ars�t�o�r�atiofl Household #: 35246
NOV 17 2015
Monon Community Center BY' drag Krstic Hm Ph: (317)564-8515
Carmel IN 46032 13500 Clifty Falls Dr. Wk Ph: (215)834-5547
Carmel IN 46032 Cell Ph:(267)394-1670
denkrstic@gmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 45.00- 45.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 45.00
Processed on 11/16/15 @ 12:09:52 by JAB NEW REFUND AMOUNT(-) 45.00
TOTAL REFUNDABLE AMOUNT 45.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 45.00 Made By==>REFUND FINAN With Reference=_>81-99-4358400 refund;parent request
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
I_I
horiz Si ature Date Authorized Signature Date
Escape Day asses 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.
Krstic, Predrag Terms
13500 Clifty Falls Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/16/15 1458446 Refund $ 45.00
Total $ 45.00
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.
Krstic, Predrag Allowed 20
13500 Clifty Falls Dr
Carmel, IN 46032
In Sum of$
$ 45.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 1458446 4358400 $ 45.00 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
Signature
$ 45.00 Business Services Director
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund