HomeMy WebLinkAbout302821 09/08/16 iT`% �,q,�f. CITY OF CARMEL, INDIANA VENDOR: 371100
.;; ® 3j• ONE CIVIC SQUARE SANDRA SWARTZ
CHECK AMOUNT: $*.*******74.00*
?q; CARMEL, INDIANA 46032 18144 STARVIEW DR CHECK NUMBER: 302821
�'��ioN'�°' WESTFIELD IN 46074 CHECK DATE: 09/08/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 2000400004 74.00 REFUNDS AWARDS & INDE
Voucher No. Warrant No.
Swartz, Sandra Allowed 20
18144 Starview Dr
Westfield, IN 46074
In Sum of$
$ 74.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 2000400004 4358400 $ 74.00 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
September 6, 2016
Signature
$ 74.00 Accounts Payable Coordinator
Cost distribution ledger classification if .Title
claim paid motor vehicle highway fund
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.
Swartz, Sandra Terms
18144 Starview Dr Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/24/16 2000400004 Refund $ 74.00
Total $ 74.00
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
20_
Clerk-Treasurer
Receipt#2000400:004 FBY-
A
VED Page 1.of 1
0 2016
Mlonon Cornrnunit Center West F "� � Y : ` _y uchef.4 41 84�a� O
Building fAug;24; 20.1.65
1195 Central Park Dr. West
Carmel, IN 4.6032.
Phone: (317) 848-7275
FAX - r M
Email: info@carmelclayparks.com Cd Coo, %te
rari
NATIONALs&Recreajon
L
SANDR+A SWARTZ
18w144aT/�RVIW DRQ NACCREDITED
i WESTFIELt3' IN 4:60.!7`74
Prepared By: staceyl
Customer ID: 19.729
Primary phone: (317) 399=6236, Secondary phone: --
Refund Summary
Check: 74.::Oa'}sCheck#,
Total Received: v $ _� Total Refund: ($74.00)
j Transactions
Customer Description Item Unit Qty Fee Charge
Sandra Swartz Escape Pass-Senior Monthly Membership Each 1.00 $37.00 ($37.00)
18144 Starvlew or Action:.Membership cancel Fee
Westfield,IN 46074 Expires:Aug 7,2016
Primary phone:(317)399- Pass r X130036574:Sandra Swartz.
6236 Thanks for your purchase!This pass will
Email:-- automatically renew each month,until cancellation
ID:19729 request Is received.Cancellation request must be
received 7 days prior to billing date.
Sandra Swartz Escape.Pass-Senior Monthly Membership Each 1.00 $37.00 ($37.00)
18144 Starview or Action: Membership.Refund Fee
Westfield,IN 46074 Expires:Aug 7,2015
Primary phone:(317).399- Pass# 130036574:Sandra Swartz
6236 Thanks for your purchase!This pass will
Email:-- automatically renew each month,until cancellation
ID:19729 request is received.Cancellation request must be
received 7 days prior to billing date.
Total Charges,($74..00)
:`Totat-Payrrientsi( 74�:Q-off
Balance $0.
Federal Tax ID # 35-6000972
https://anprod.active.com/`carmelelayparks/servlet/prpcessReceiptpayment.sdi 8/24/2016