187320 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 364309 Page 1 of 1
0 ONE CIVIC SQUARE HERMAWAN HARANTO
CARMEL, INDIANA 46032 9672 AVENEL COURT CHECK AMOUNT: $51.00
4y� oN CARMEL IN 46032 CHECK NUMBER: 187320
CHECK DATE: 7!712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 449488 51.00 REFUNDS AWARDS INDE
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Receipt 449488
Payment Date: 06/21/10
Household 35106
Monon Community Center Hermawran Harfanto Hm Ph: (317)876 -7488
Carmel IN 46032 9672 Avenel Court
Carmel IN 46032 Cell Ph: (317)331 -7888
PFiune: (317)848 -7275 hhartanto888@yahoo.com
Fed Tax ID #35- 6000972
Refund Details
Oria Ball Refund New Bal
Module: Activity Registration 51.00- 51.00 0.00
GIL Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) i=nter Contrd Acct CNTRL Control Armrmt (AP) Enter Control Acct here 51.00 DR
Finance will have to DEBIT the CONTROL account for the arnoun s fisted above after the checks have been written to the eustwrrers.
PREVIOUS NET HOUSEHOLD BALANCE 51.00
Processed on 06/21/10 10:56:39 by CNA NEW REFUND AMOUNT 51.00
TOTAL REFUNDABLE AMOUNT 51.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 51.00 Made By REFUND FINAN Wish Reference broken foot
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.
(0 2( o
Au orized Signature Dale AuthorVed Signature Date
Ra
JUN 2 3 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.
Hartanto, Hermawan Terms
9672 Avenel Court Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/21/10 449488. 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.
Hartanto, Hermawan Allowed 20
9672 Avenel Court
Carmel, IN 46032
In Sum of
51.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -42 449488 4358400 51.00 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
1 -Jul 2010
Signature
51.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund