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HomeMy WebLinkAbout182073 02/03/2010 a CITY OF CARMEL, INDIANA VENDOR: 363856 Page 1 of 1 74 ONE CIVIC SQUARE CHRISTINA ROSE CARMEL, INDIANA 46032 6528AMHERST WAY CHECK AMOUNT: $55.50 -,'4, ZIONSVILLE IN 46077 CHECK NUMBER: 182073 CHECK DATE: 2/3/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 55.50 REFUND IV PASS REFUND RECEIPT Receipt 378161 Payment Date: 01/17/10 Household 20571 Monon Center Christina Rose Hm Ph: (317)769 -4281 Carmel IN 46032 6528 Amherst Way Zionsville IN 46077 Cell Ph: christinateeter @yahoo.com Bone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 55.50 Pass Holder: Christina Rose Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: KZ 50 Visit (M Z50), #82517 19.50 0.00 19.50 0.00 0.00 Valid Dates: 09/24/2009 to 12/31/2099 Pass Cancellation) Pass Visit Info: Number of Visits: 37 Cancel Reason: new rates /KZ included 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 55.50 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 HOUSEHOLD BALANCE 0.00 Processed on 01/17/10 13:50.19 by RDG FEES CHANGED ON CANCELLED ITEMS 55.50 NET AMOUNT.>FROM.CANCELLED IT,EMSD 55.50d I' :TOTAL AMOUNT;REFUNDEDF:::"'";"'.' r 55;50'. NEW NET HOUSEHOLD BALANCE 0.00 Refund of 55.50 Made By REFUND FINAN With Reference All refundsfixe- subject to State Bo' d --of Acca is claim procedure and may take 4 -6 weeks to process. A check will be issued o cash or credit card ref nds. n" t 1 i 4 1 \i t Signature Date Authorized Signature Date 4 7 (CO e eD 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. Rose, Christina Terms 6528 Amherst Way Date Due Zionsville, IN 46077 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/17/10 378161 Refund 55.50 Total 55.50 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. Rose, Christina Allowed 20 6528 Amherst Way Zionsville, IN 46077 In Sum of$ 55.50 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or Board Members INVOICE NO. ACCT #/TITLE AMOUNT Dept 1092 378161 4358400 55.50 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 28 -Jan 2010 Signature 55.50 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund