HomeMy WebLinkAbout182429 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.
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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.
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