181406 01/13/2010 INDIANA
o CITY OF CARMEL VENDOR: 363767 Page 1 of 1
f ONE CIVIC SQUARE SUSAN TETRICK CHECK AMOUNT: $82.11
CARMEL, INDIANA 46032 2824 E 98TH ST
INDIANAPOLIS IN 46289 CHECK NUMBER: 181406
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 82.11 REFUND
PASS REFUND RECEIPT
Receipt G3
Payment Date:
Household 14839
Monon Center I_Susan Tetrick Hm Ph: (317)844 -2154
Carmel IN 46032 2824- E- 98th)Street, Wk Ph: (317)896 -5582
rIndianapolis -I -IN -46280 Ext. 101
Cell Ph: (317)966 -9972
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 82.11
Pass Holder: Susan Tetrick Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: UnGrpFit Annual (M UGFA), #64366 192.89 0.00 192.89 0.00 0.00
Valid Dates: 04/18/2009 to 04/18/2010 Pass Cancellation)
Cancel Reason: transfering to MC HH which includes fitness classes__
G/L Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 82.11 DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers.
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 7.00
Processed on 12/30/09 05:47:56 by RDG FEES CHANGED ON CANCELLED ITEMS 82.11
P .NETiAMOUNi :FROM CANCELL`'ED. =ITE
(;';TOTAL AMOUNT REFUNDED f .82:;11'
NEW NET CREDIT HOUSEHOLD BALANCE 7.00
Refund of 82.11 Made By REFUND FINAN With Reference
All refunds are subject Kga e Boar of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit car refu s.
Authored Signature y Date Authorized Signature Date
Look SS W
JAN 0 7 a10
Page 1
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.
Tetrick, Susan Terms
2824 E 98th Street Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/09 368929 Refund 82.11
Total 82.11
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.
Tetrick, Susan Allowed 20
2824 E 98th Street
Indianapolis, IN 46280
In Surn of
82.11
ON ACCOUNT OF APPROPRIATION FOR
l(
PO# or Board Members
INVOICE NO. ACCT #!TITLE AMOUNT
Dept
368929 4358400 82.11 I 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
7 -Jan 2010
Signature
82.11 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund