HomeMy WebLinkAbout253242 01/11/16 �4iq
4y� 3f CITY OF CARMEL, INDIANA VENDOR: 370174
`` tf CHECK AMOUNT: $rraaar*297.00•
}• ONE CIVIC SQUARE DIANE WEMMER
�, ;i� CARMEL, INDIANA 46032 4736 HAVENLAKE RD,APT E CHECK NUMBER: 253242
9M��TpN�°' INDIANAPOLIS IN 46280 CHECK DATE: 01/11/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 1258767 297.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
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�.60913 ,�aeyDate 14 .
DE"; 17 2015
DIANE WEMMER ' Monon Community Center
473AUENLAKE R Carmel IN 46032
APT.E ,
INDIANAPOLIS��1�:���280
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION -Refund Of 297.00
Pass Holder: Diane Wemmer Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC HH Mthly(M MCHHM),#250206 198.00 0.00 198.00 0.00 0.00
Valid Dates: 07/31/2015 to 07/31/2016 (Pass Cancellation)
Cancellation Effective: 12/17/2015
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
nMonthly MC Pass 198.00 1.00 0.00 0.00 198.00
Cancel Reason: Staff Error
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 12/17/15 @ 13:12:55 by DMLEONARD FEES CHANGED ON CANCELLED ITEMS(+) 297.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES(-) 0.00
SALES TAX CHARGED ON CANCELLED FEES(+) 0.00
``NET AMOUNTFROM CANCELL"ED ITEMS 297:00
TOTAL AMOUNT REFUNDED STttOt
10CM. 43S-Vino NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 297.00 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. q ,, yy r I" .,,
12-117 11
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Authorized re Date Authorized Signature Date
Escape Day Passes are non-refundable.
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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.
Wemmer, Diane Terms
4736 Havenlake Rd Apt E Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/17/15 1258767 Refund $ 297.00
Total $ 297.00
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
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Clerk-Treasurer
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Voucher No. Warrant No.
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\8ennmer, Diane . Allowed 20____
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4738HavnnbakoRdApt E /
Indianapolis, IN 48280
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. � In Sum
ONACCOUNT OF APPROPRIATION FOR �
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109 -MCCPO#or '
-----�� Board Members
INVOICE
ACCT#MTLE AMOUNT
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1092 1258767 4358400 $ 297.00 | hereby certify that the attached invoico(n)' or
� bi||(m)is(am)true and correct and that the
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materials orservices itemized thereon for
which charge ismade were ordered and
received except
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iDecember 28,2015
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Signature
---� / Coordinator
` Accounts .
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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