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Home My WebLink About182429 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 363892 Page 1 of 1 ONE CIVIC SQUARE YONG LACY CHECK AMOUNT: $630.00 CARMEL, INDIANA 46032 5249 CHEYENNE MOON CARMEL IN 46033 CHECK NUMBER: 182429 CHECK DATE: 2/17/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4358400 384332 630.00 REFUNDS AWARDS INDE PASS REFUND RECEIPT Receipt 384332 Payment Date: 02/04/10 Household 1593 FEES 05 2010 Mcnon Center Yong Lacy Hm Ph: (317)815 -9306 Carmel IN 46032 5249 Cheyenne Moon Wk Ph: (317)810 -3789 13yC Carmel IN 46033 Cell Ph: (317)513 -6809 jeanniel @indy.rr.com Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 250.00 Pass Holder: Tara Lacy Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: 20 -Visit (ESE20V), #33946 0.00 0.00 0.00 0.00 0.00 Valid Dates: 08/11/2009 to 05/2712010 Pass Cancellation) Pass Visa Info: Number of Visits: 20 CANCELLATION Refund Of 250.00 Pass Holder: Courtney Lacy Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: 20 Visit (ESE20V) #33949 0.00 0.00 0.00 0.00 0.00 Valid Dates: 08/11/2009 to 05/27/2010 Pass Cancellation) Pass Visit Info: Number of Visits: 20 CANCELLATION Refund Of 130.00 Pass Holder: Courtney Lacy Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: 10 -Visit (ESE10V), #62151 0.00 0.00 0.00 0.00 0.00 Valid Dates: 08/11/2009 to 05/27/2010 Pass Cancellation) Pass Visit Info: Number of Visits: 10 G/L C ode Description Account Number Csl Cntr Description Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 630.00 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 02104/10 11:02:25 by JAB FEES CHANGED ON CANCELLED ITEMS 630.00 t/ NET AMOUNT FROM CANCELLED ITEMS 630.00- [fL� 0Z•U►'�"- l� TOTAL AMOUNT REFUNDED 630.00 435 `1 J-} NEW NET HOUSEHOLD BALANCE 0.00 Refund of 630.00 Made By REFUND FINAN With Reference check refund All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issued. No cash or credit card refunds. Page 1 WN 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. Lacy, Yong Terms 5249 Cheyenne Moon Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 214/10 384332 Refund 630.00 Total 630.00 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 1 20 Clerk- Treasurer Voucher No, Warrant No. Lacy, Yong Allowed 20 5249 Cheyenne Moon Carmel, IN 46033 In Sum of 630.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -7 384332 4358400 630.00 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 11 -Feb 2010 Signature 630.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund