188036 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364437 Page 1 of 1
ONE CIVIC SQUARE JAMES ROBINSON CHECK AMOUNT: $168.84
CARMEL, INDIANA 46032 11501 SENIE LANE
CARMEL IN 46032 CHECK NUMBER: 188036
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 466133 168.84 REFUNDS AWARDS INDE
L GLOBAL REFUND RECEIPT
Receipt# 466133
Payment Date: 07/07110
Household 4706
Monon Community Center James Robinson Hm Ph: (317)587 -0066
Carmel IN 46032 11501 Senie lane Wk Ph: (317)
Carmel IN 46032 Cell Ph:
jimrobinsonfsa @earthlink.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 168.84- 168.84 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 168.84
Processed on 07/07/10 13:07:39 by TLP NEW REFUND AMOUNT 168.84
TOTAL REFUNDABLE AMOUNT 168.84
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 168.84 Made By REFUND FINAN With Referenc upgraded to hh �,-inc�ludmgli
All refunds a e. subject to Stat Board of ou s claim procedure and may take 4 -6 weeks to process. A check will be
issued .flo cash or credit refu
7&)
/Au orized Signat a Date Authorized Signature Date
JUL 2010
BY:
Page 9 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.
Terms
Robinson, games
Date Due
11501 Senie Lane
Carmel, IN 46032
Invoice Invoice Description
or note attached invoice(s) or bill(s)) Amount
Date Number 168.84
717/10 466133 Refund
Total 168.84
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.
Robinson, James Allowed 20
11501 Senie Lane
Carmel, IN 46032
In Sum of
168.84
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT */TITLE AMOUNT Board Members
Dept
1092 466133 4358400 168.84 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
168.84 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund