187927 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364148 Page 1 of 1
s` 0 ONE CIVIC SQUARE ETHEL LAWLISS CHECK AMOUNT: $98.00
la CARMEL, INDIANA 46032 10315 RUCKLE
INDIANAPOLIS IN 46280 CHECK NUMBER: 187927
CHECK DATE: 7121/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 468488 98.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 468488
Payment Date: 07110(10
Household 34138
Monon Community Center Ethel Lawliss Hm Ph: (317)846 -8860
Carmel IN 46032 10315 Ruckle
Indianapolis IN 46280 Cell Ph: (317)844 -5142
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 98.00- 98.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 98.00
Processed on 07/10/10 11:52:35 by MML NEW REFUND AMOUNT 98.00
TOTAL REFUNDABLE AMOUNT 98.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 98.00 Made By REFUND FINAN With Reference low enrollment 10 /q
All refunds are s bject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issu o as r cre it card refunds.
Z -7 1 '(7
Authonze Si ature bate Autho zed Signature Date
ro'�( f5c) .L� )is o
JUL 1 a 2010 bu ll
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.
Lawliss, Ethel Terms
10315 Ruckle Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7110110 468488 Refund 98.00
Total 98.00
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- 14 -1.6
1 20
Clerk- Treasurer
Voucher No. Warrant No,
Lawliss, Ethel Allowed 20
10315 Ruckle
Indianapolis, IN 46280
In Sum of
98.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #£TITLE AMOUNT Board Members
Dept
1096 -50 468488 4358400 98.00 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
98.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund