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HomeMy WebLinkAbout326578 06/28/2018 `%'��p\'' CITY OF CARMEL, INDIANA VENDOR: T362687 'i. CHECK AMOUNT: $*******243.94* .�: ONE CIVIC SQUARE GREGORY GORSKI :9 �� CARMEL, INDIANA 46032 1746 ALTAVISTA CIRCLE CHECK NUMBER: 326578 .y��ioN�°, LAKELAND FL 33810 CHECK DATE: 06/28/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 2000826004 243.94 REFUNDS AWARDS & INDE ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Gorski, Gregory Payee ,(ftp 1746 Altavista Circle `\ Lakeland, FL 33810 In Sum of$ Purchase Order# Gorski, Gregory Terms $ 243.94 1746 Altavista Circle Date Due Lakeland, FL 33810 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO#or Invoice nvolce Description Dept# INVOICE NO. ACCT#/TITLE AMOUNT Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1092 2000826004 4358400 $ 243.94 Board Members 6/13/18 2000826004 Refund $ 243.94 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 $ 243.94 Total $ 243.94 June 21,2018 I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance Y with IC 5-11-10-1.6 Cost distribution ledger classification if claim paid motor vehicle highway fund Signature 20_ Accounts Payable Coordinator Clerk-Treasurer Title Receipt#2000826.004 Page 1 of 1 a *: Monon Community Center West VDu ,Ker " # 0000$_26.004 Building J'un 13, 218 .4'0'PM- y 1195 Central Park Dr. West Carmel, IN 46032 Phone: (317) 848-7275 � ► 4oft Clay . FAX: arlarwi lel .* Email.. info@carmelclayparks.com Nrks&Recreali Nab Irl GOLD MEDAL WINNER ME ORY GORSK�I� new adts ACCREDITED AGENCY �e UVjPrepared By: hollypg . .Loot aAA Customer ID: 11175 Primary phone: (317) 848-2511, Secondary phone: (317) 848-2511 Refund Summary heck: ($243:9}4)Cfieck Total Received: ($243.94) 0 ,51-M fu-nd:- - - - Transactions Customer Description Item Unit Qty Fee Charge Gregory Gorski Senior Annual (Legacy) Pass Membership Each 1.00 $243.94 ($243.94) 13164 Derbyshire'Court Action:Membership Cancel Fee Carmel,iN 46032 Expires: Mar 31,2018 Primary phone:(317)848- Pass# 130001967: Gregory Gorski 2511 Thanks for your purchase! Email:mom5752@att.net ID: 11175 Total Charges ($243.94) Total Payments ($243.94) Balance $0 Fy- c)q '77�'i F, K-5 - Federal Tax ID # 35-6000972 1 8 2018 2. . 6) C� https://anprod.active.com/carmelclayparks/servlet/processReceiptPayment.sdi 6/13/2018