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Home My WebLink About186949 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 364261 Page 1 of 1 ONE CIVIC SQUARE VIRGINIA MOSBAUGH c CARMEL, INDIANA 46032 1227 KINGS COVE CT CHECK AMOUNT: $170.00 INDIANAPOLIS IN 46260 CHECK NUMBER: 186949 CHECK DATE: 6/23/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 432904 170.00 REFUNDS AWARDS INDE t PASS REFUND RECEIPT T Receipt 432904 `r Payment Date: 06/04/2010 Household 35269 J 0 7 Home Phone: (317)818 -8911 Work Phone: (317) Y o VIRGINIA MOSBAUGH Monon Community Center 1227 KINGS COVE CT Carmel IN 46032 INDIANAPOLIS IN 46260 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 85.00 Pass Holder: Virginia Mosbaugh Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Seas AQ Adult (SAQAR), #108110 0.00 0.00 0.00 0.00 0.00 Valid Dates: 05/29/2010 to 09/06/2010 Pass Cancellation) Cancel Reason: Pool too crowded,no adult areas, not what we expected. CANCELLATION Refund Of 85.00 Pass Holder: Lars Horne Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Seas AQ Adult (SAQAR), #108109 0.00 0.00 0.00 0.00 0.00 Valid Dates: 05/29/2010 to 09/06/2010 Pass Cancellation) Cancel Reason: Pool too crowded,no adult areas, not what we expected. G/L Code Description Account Number Cst Cntr Descripti Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 170.00 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 06/04 /10 12:02:09 by CRB FEES CHANGED ON CANCELLED ITEMS 170.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 FIN ETr%MOUNTgFROWCANGELLED )ITEMS r 170100 TOTAL�;'AM00NTiREFUNDEDE C t r ,170[00: Y` IrQ NEW NET HOUSEHOLD BALANCE 0.00 Refund of 170.00 Made By REFUND FINAN With Reference Page 1 5 PASS REFUND RECEIPT Receipt 432904 Payment Date: 06/04/2010 Household 35269 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. Authorized Signature Date Authorized Signature Date JUG Page 2 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. Mosbaugh, Virginia Terms 1227 Kings Cove Ct Date Due Indianapolis, IN 46260 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 614110 432904 Refund 170.00 Total 170.00 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. Mosbaugh, Virginia Allowed 20 1227 Kings Cove Ct Indianapolis, IN 46260 In Sum of$ 170.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members Dept 1(0 9A 432904 4358400 170.00 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 17 -Jun 2010 Signature 170.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund