181338 01/13/2010 o' c Z, CITY OF CARMEL, INDIANA VENDOR: 363765 Page 1 of 1
d` ONE CIVIC SQUARE CLAIRE OSBORNE
CHECK AMOUNT: $162.37
a CARMEL, INDIANA 46032 10428 HIGH GROVE
`e CARMEL IN 46032
CHECK NUMBER: 181338
CHECK DATE: 1113!2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 162.37 REFUNDS AWARDS INDE
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O@OOrV&OUO!O
Monon Center Clerk:
RDG
Date:rI�/Z]/ZDO&��� 1�l,7r��~----
Time: 05:43:42
JAN 0 7 2010 H/H: 7 Li`
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F/M: }3y
9 '03 2 7_
Description Ext Price
Rcpt# 367019 Prev Bal: I62'37-
New Charges 0'00 LJ
New Tax: 0.00 (C)-
Total Due: 162'37- ,j
Tot Refund:
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37� ,\`2�
p c.`2/1 D2/
New Bal: 0 O0 /`��iN y
k` L
Refund Type: Refund from Finance 4v� D` �0�~��'
REFUND FINAN R efund of: I62 37
n i /o<
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All refunds are subject to State Board 'r I
of Accounts claim procedure
�oc�dure and may take ��c�
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4 6 k to pr cess. 'ck will be [�v` n 4i�
issued. or cr
T U utho at 8�z v
/8�
Authorized Signature Date
Fed Tax ID 35-6000972
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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.
Osborne, Claire Terms
10428 High Grove Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/23/09 367019 Refund 162.37
Total 162.37
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
Voucher No. Warrant No.
Osborne, Claire Allowed 20
10428 High Grove
Carmel, IN 46032
In Sum of
162.37
ON ACCOUNT OF APPROPRIATION FOR
-1-04—Prograrrr Fund
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
367019 4358400 162.37 I hereby certify that the attached invoice(s), or
4092 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
7 -Jan 2010
Signature
162.37 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund