HomeMy WebLinkAbout188904 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 364539 Page 1 of 1
ONE CIVIC SQUARE UMARIN MAHAMAT
CARMEL, INDIANA 46032 816 SCHOEN CT, APT E CHECK AMOUNT: $112.00
CARMEL IN 46032
CHECK NUMBER: 188904
CHECK DATE: 8/18/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 4998974 112.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 499874
Payment Date: 08/09/10
Household 35316
Monon Community Center Umarin Mahamat Hm Ph: (407)748 -6856
Carmel IN 46032 816 Schoen Ct.
Carmel IN 46032 Cell Ph:
umahamat@yahoo.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Orio Bat Refund New Bal
Module: Activity Registration 112.00 112.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 112.00
Processed on 08/09/10 09:25:45 by LVA NEW REFUND AMOUNT 112.00
TOTAL REFUNDABLE AMOUNT.
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 112.00 Made By REFUND FINAN With Reference low enrollment
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issu o cash or cred't c rd refunds.
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Authorized Sign re Date Auth rized nature Date
ENJOY YOUR ESCAPE! �y
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BY:
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Mahamat, Umarin Terms
816 Schoen Ct., Apt E Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
819110 4998974 Refund 112.00
Total 112.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
.20
Clerk- Treasurer
Voucher No. Warrant No.
Mahamat, Umarin Allowed 20
816 Schoen Ct., Apt E
Carmel, IN 46032
In Sum of$
112.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -42 4998974 4358400 112.00 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
12 -Aug 2010
Signature
112.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund