188441 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 364501 Page 1 of 1
Q� ONE CIVIC SQUARE MEHRAN MOJARRAD CHECK AMOUNT: $644.00
CARMEL, INDIANA 46032 40018 IVORY CT
WESTFIELDIN 46074 CHECK NUMBER: 188441
CHECK DATE: 8/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 481562 644.00 REFUNDS AWARDS INDE
GLOBAL REFUND RECEIPT
Receipt 481562
Payment Date: 07/21/10
Household 20171
Mortion Community Center Mehran Mojarrad Hm Ph: (317)733 -8828
Carmel IN 46032 4018 Ivory Ct Wk Ph: (317)276 -7795
Westfield IN 46074 Cell Ph: (317)640 -2221
mojarradme@lilly.com
Phone: (317)848-7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 644.00- 644.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 644.00
Processed on 07/21/10 16:08:09 by BJJ NEW REFUND AMOUNT 644.00
TOTAL REFUNDABLE AMOUNT
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 644.00 Made By REFUND FINAN With Reference
All refund are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. o cash or credit card refunds.
t ut -ed Signature Date Authorized Signature Date
Enjoy your escape at the MCC.
L
JUL 2 3 2010
0q T 13Y A
P
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.
Mojarrad, Mehran Terms
4
4018 Ivory Ct Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7121110 481562 Refund 644.00
Total 644.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and t have audited same in accordance
with IC 5- 11- 10 -1.6
20�
Clerk Treasurer
Voucher No. Warrant No.
Mojarrad, Mehran Allowed 20
4018 Ivory Ct
Westfield, IN 46074
In Sum of
644.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -1 481562 4358400 644.00 1 hereby certify that the attached invoice(s), or
bilt(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
29 -Jul 2010
Signature
644.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund