182475 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 363894 Page 1 of 1
ONE CIVIC SQUARE COURTNEY O'NEIL CHECK AMOUNT: $51.00
CARMEL, INDIANA 46032 12665 APSLEY LANE
CARMEL IN 46032
CHECK NUMBER: 182475
CHECK DATE: 2/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 383762 51.00 REFUNDS AWARDS 1NDE
PASS REFUND RECEIPT
Receipt 383762
Payment Date: 02/02/10
Household 24533
Monon Center Courtney O'neil Hm Ph: (317)869 -6600
Carmel IN 46032 12665 Apsley Lane
Carmel IN 46032 Cell Ph:
courtney.oneil @yahoo.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Orio Bal Refund New Bal
Module: Pass Management 51.00- 51.00 0.00
G /L Description Account Numbe CstCntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 51.00 DR
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 51.00
Processed on 02/02/10 16:07:46 by LVA NEW REFUND AMOUNT 51,00
TOTAL REFUNDABLE AMOUNT 51.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 51.00 Made By REFUND FINAN With Reference advanced request
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.
ZI i� la
Authorized Sign al e D to I Auth rized Signature Date
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FEB 1 1 �Q1Q
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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.
O'Neil, Courtney Terms
12665 Apsley Lane Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
212110 383762 Refund 51.00
Total 51.00
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
O'Neil, Courtney Allowed 20
12665 Apsley Lane
Carmel, IN 46032
In Sum of
51.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT#1TITLE AMOUNT Board Members
Dept
1096 -41 383762 4358400 51.00 f 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
51.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund