188046 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364439 Page 1 of 1
ONE CIVIC SQUARE MICHAEL SACHS CHECK AMOUNT: $104.00
CARMEL, INDIANA 46032 4703 BEDFORD CT
•ti .off La CARMEL IN 46033 CHECK NUMBER: 188046
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 466181 104.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 466181
Payment Date: 07/06/10
Household 7643
Monon Community Center Michael Sachs Hm Ph: (317)580 -9788
Carmel IN 46032 4703 Bedford Ct Wk Ph: (317)636 -9316
Carmel IN 46033 Ext. 14
Phone: (317)848 -7275 mojomosa @aol.com Cell Ph: (317)716 -7334
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 104.00- 104.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 104.00
Processed on 07/06/10 13:25:23 by ERM NEW REFUND AMOUNT 104.00
TOTAL REFUNDABL`•E +AMOUNT. 104:00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 104.00 Made By REFUND FINAN With Reference Credit to Refund
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.
7 17110
Authorized Signature Datl Authorized Signature Date
JUL
4 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
Sachs, Michael Purchase Order No.
4703 Bedford Ct Terms
Carmel, IN 46033 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)}
7/6/10 466181 Refund Amount
104.00
1 hereby certify that the attached invoice(s), or bilf(s) is (are) true and correct and I have audited same in accordance 104.00
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
Sachs, Michael Allowed 20
4703 Bedford Ct
Carmel, IN 4603 3
In Sum of
104.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -10 466181 4358400 104.00 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
104.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i