HomeMy WebLinkAbout186956 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 364262 Page 1 of 1
j: ONE CIVIC SQUARE PAMELA NETTLETON
CARMEL, INDIANA 46032 10518 CONNAUGHT DRIVE CHECK AMOUNT: $200.00
CARMEL IN 46032
CHECK NUMBER: 186956
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 432474 200.00 REFUNDS AWARDS INDE
;r
PASS REFUND RECEIPT
Receipt 432474
Payment Date: 06/03/10
Household 10619
Monon Center Pamela Nettleton Hm Ph: (317)879 -8413
Carmel IN 46032 10518 Connaught Drive Wk Ph: (317)896 -5525
Carmel IN 46032 Cell Ph: (317)625 -4460
pamn29 @sbcglobal.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 200.00
Pass Holder: Amanda Nettleton Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: 20 -Visit (ESE20V), #76735 50.00 0.00 50.00 0.00 0.00
Valid Dates: 08/11/2009 to 05/27/2010 Pass Cancellation)
Pass Visit Info: Number of Visits: 16
Cancel Reason: will no longer use ESE program
G/L Code Description Account Number Cst C ntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 200.00 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 06/03110 15:03:01 by JAB FEES CHANGED ON CANCELLED ITEMS 200.00
NET AMOUNT FROM CANCELLED ITEMS 200.00
TOTAL AMOUNT REFUNDED 200.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 200.00 Made By REFUND FINAN With Reference check refund
All efunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
ssue No C
ash or credit card r funds.
0
Auth ed S nature Date Authorized Signature Date
JUN 0 4 2010
Y� t
L� vy 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,
Nettleton, Pamela Terms
10518 Connaught Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
613110 432474 Refund 200.00
Total 200.00
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.
Nettleton, Pamela Allowed 20
10518 Connaught Drive
Carmel, IN 46032
In Sum of$
200.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #ITITL AMOUNT Board Members
Dept
1081 -9 432474 4358400 200.00 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
200.00 Accounts Payable Coordlnator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund