HomeMy WebLinkAbout255407 02/12/16 I
Voucher No. Warrant No.
Thomas, Suzanne Allowed 20
13517 Brookshire Pkwy
Carmel, IN 46033
In Sum of$
$ 140.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
i
i
PO#or._ INVOICE NO. ACCT#/TITLE AMOUNT . Board Members
Dept#
.1081-5 1458777 4358400 $ 140.00 1 hereby certify that the attached invoice(s), or
i 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
February 5, 2016
I
4 Signature
$ 140.00 Business Services Director
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i
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.
Thomas, Suzanne Terms
13517 Brookshire Pkwy Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/6/16 1458777 Refund $ 140.00
Tot-a-1-F$ 140.00
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
20_
Clerk-Treasurer
• i
PASS REFUND RECEIPT
Rece�p #,;,���
Carmel a Payment Date 01/U6/16
Hotasehol'd
f rksAccrcation
RECEIVED � . .
Monon Community Center �Suzattne Thoslla Hm Ph: (561)307-8737
Carmel IN 46032 135ATBrooks�iire Pkwy.
FEB — 5 2016 CRrrr�I,' ' °46b a 4 Cell Ph:(502)974-2002
;ti ttornas36641@bellsouth;. .t
Phone: (317)848-7275 �Y: �Y'ra '�tI,;,u�ttiF``
Fed Tax ID#35-6000972
Pass Details
CANCELLATION -Refund Of 140.00
Pass Holder: Annie Thomas Fees+Tax Discount Prey Paid Cur Paid Amount Due
Pass:Type: 1.0-V'tsit(ESE1OV),#260019 0.00 0.00 0.00 .0.00 0.00
Valid Dates: 08/13/2014 to 05/27%2015 (Pass Cancellation)
Cancellation Effective: 01/06/2016
Cancel Reason: no longer use ese(carryover punch card visits)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 01/06/16 @ 13:12:03 by BJJ FEES CHANGED ON CANCELLED ITEMS(+} 140.00-
NET AMOUNT'FROM CANCELLED'ITEMS' 140.00-
OT0TALEAMOUNT REFUNDED s{a '-.140.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of==> 140.00 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.
issyled.
uthorized Signature Date Authorized Signature Date
,Escape Day Passes are non-refundable.
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