HomeMy WebLinkAbout187243 07/07/2010 CITY OF CARMEL, INDIANA VENDOR. 364300 Page 1 of 1
f ONE CIVIC SQUARE TIMOTHY BUCKHORN CHECK AMOUNT: $170.00
4 /o CARMEL, INDIANA 46032 13667 CHESWICK BLVD
<r CARMEL IN 46032 CHECK NUMBER: 187243
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 457003 170.00 REFUNDS AWARDS INDE
R
GLOBAL REFUND RECEIPT
Receipt 457003
Payment Date: 06/29/10
Household 35299
Monon Community Center Timothy Buckhorn
Carmel IN 46032 13667 Cheswick Blvd
Carmel IN 46032 Cell Ph: (317)
Phosie: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 170.00- 170.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 170.00
Processed on 06/29/10 11:07:16 by TLP NEW REFUND AMOUNT 170.00
TOTAL REFUNDABLE AMOUNT 170.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 170.00 Made By R ND FINAN ith eference injury unable to use; No visits on history
All refun -are subject to Sta Bo of A o s imp cedure and may take 4 -6 weeks to process. A check will be
iss No cash or �redit c unds.
Authorized Sig atur to Authorized Signature Date
J Ak
7 JUL 0 2 2010
BY......
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.
Buckhorn, Timothy Terms
13667 Cheswick Blvd Date Due
Carmel, IN 46032
l-
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6129110 457003 Refund 170.00
Total 170.00
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.
Buckhorn, Timothy Allowed 20
13667 Cheswick Blvd
Carmel, IN 46032
In Sum of
170.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 457003 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
2 -Jul 2010
��.P/Y1�1.lYV� OIr
Signature
170.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund