HomeMy WebLinkAbout187920 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364427 Page 1 of 1
ONE CIVIC SQUARE JENNIFER KOST- BARKER
CARMEL, INDIANA 46032 819 W ADMAN DR CHECK AMOUNT: $35.00
CARMEL IN 46032
CHECK NUMBER: 187920
CHECK DATE: 7/2112010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 458904 35.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 458904
Payment Date: 07101/10
Household 3273
Monon Community Center Jennifer Kost Barker Hm Ph: (317)571 -0354
Carmel IN 46032 819 W Auman Dr. Wk Ph: (317)
Carmel IN 46032 Cell Ph: (317)331-2295
jennfer.kost-bakeer@rci.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 35.00
Pass Holder: Jenifer KOst Barker Fees-Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly (M MCAM), #72360 0.00 0.00 0.00 0.00 0.00
Valid Dates: 06/07/2010 to 06/20/2011 Pass Cancellation
Cancel Reason: guest states she cancelled pass march. No paperwork found to support. should ha�been
cancelled 6/5/10. TLP
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07101/10 09:54:26 by TLP FEES CHANGED ON CANCELLED ITEMS 35.00
NET AMOUNT FROM CANCELLED ITEMS TOTAL AMOUNT AMOUNT REFUNDED 35.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 35.00 Made By REFUND FINAN Wi Reference
All refunds are subject to S Board of claim procedure and may take 4 -6 weeks to process. A check will be
issue cash or cred' car ref
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Authorized 5igna re Date Authorized Signature Date
llRfi' Qi
Ja;L. 2 1010
BY....
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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.
y Payee
Purchase Order No.
Kost Barker, Jennifer Terms
819 W Auman Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
711110 458904 Refund 35.00
Total 35.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Kost Barker, Jennifer Allowed 20
819 W Auman Dr
Carmel, IN 46032
In Sum of
r
35.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1092 458904 4358400 35.00 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
15 -Jul 2010
Signature
35.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund