HomeMy WebLinkAbout253170 01/11/16 CITY OF CARMEL, INDIANA VENDOR: 370175
ONE CIVIC SQUARE RICHARD PASSMAN CHECK AMOUNT: $********38.00*
CARMEL, INDIANA 46032 3510 W 151 ST CHECK NUMBER: 253170
WESTFIELD IN 46074 CHECK DATE: 01/11/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 1458773 38.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Re,,eeip{R# 6,1 aKrm
Payment Date l hz 1ti2>1/20x15""�7 13
_ '
Mf'dusehold#:" :' r 58664` ` a}, r� I- s& Er- Ecn..
Home Phone: (317)409-0476 rFC '° �V,
DEC ; 201
�tICF'ARD PASSMAN• ___ ___ Monon Community Center
351�OzW15'1STr Carmel IN 46032
�'WESTEIELD'IN 46074
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION -Refund Of 38.00
Pass Holder: Richard Passman Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly(M MCAM),#239941 391.00 0.00 0.00 391.00 0.00
Valid Dates: 04/09/2014 to 04/09/2015 (Pass Cancellation)
Cancellation Effective: 12/21/2015
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
nMonthly MC Pass 391.00 1.00 0.00 0.00 391.00
Cancel Reason: Refunding per Preston (he does not have a manager rectrac account). Guest cancelled in Nov.and due one
month's refund.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 12/21/15 @ 14:50:47 by MCALLAWAY FEES CHANGED ON CANCELLED ITEMS(+) 429.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES(-) 0.00
SALES TAX CHARGED ON CANCELLED FEES(+) 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES() 391.00-
`'NET,AMOUNT FROM-CANCELLED:ITEMS,
TOTAL°AMOUNTREFUNDED"
NEW NET HOUSEHOLD BALANCE 0.00 �6
Refund of=_> 38.00 Made By=_>REFUND FINAN With Reference==>
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued. pQr
avYIL I a 2 9�7—/' I z a r.'
Authodz d Signature U Date Aut or ed Ognature bate
Escape Day Passes are non-refundable. I p 12— W 3S 8 W U
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.
Passman, Richard Terms
3510 W 151 St Date Due
Westfield, IN 46074
invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/21/15 1458773 Refund $ 38.00
Total $ 38.00
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
720
Clerk-Treasurer
Voucher No. Warrant No.
Passman, Richard Allowed 20
3510 W 151 St
Westfield, IN 46074
In Sum of$
$ 38.00
I
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
Po#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 1458773 4358400 $ 38.00 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
December 28, 2015
Signature
$ 38.00 Accounts Payable Coordinator
'Cost distribution ledger classification if Title
claim paid motor vehicle highway fund