HomeMy WebLinkAbout189373 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 364637 Page 1 of 1
ONE CIVIC SQUARE GENE HOLLANDER
CHECK AMOUNT: $125.00
CARMEL, INDIANA 46032 12692 CHARING CROSS ROAD
CARMEL IN 46033 CHECK NUMBER: 189373
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 125.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 509060
Payment Date: 08/17/10
Household 25384
Morton Community Center Gene Hollander Hm Ph: (317)846 -5119
Carmel IN 46032 12692 Charing Cross Road
Carmel IN 46033 Cell Ph:
mbhcarmel @sbcglobal.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 125.00
Pass Holder: Gene Hollander Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: UnGrpFit Season (M UGFS), #114437 0.00 0.00 0.00 0.00 0.00
Valid Dates: 08/13/2010 to 12/13/2010 Pass Cancellation)
Cancel Reason wife bought him the pass. no visits on history since purchase.
PREVIOUS NET HOUSEHOLD BALANCE. 0.00
Processed on 08/17/10 21:56:17 by TLP FEES CHANGED ON CANCELLED ITEMS 125.00
NET AMOUNT FROM CANCELLED ITEMS 125.00.
TOTAL AMOUNT REFUNDED 125.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 125.00 Made By REFUND F With Reference
All refunds are subject to to e Board�ac hunts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit c d refun f°
r
Authorized Signature ate Authorized Signature Date
ENJOY YOUR ESCAPE!!!
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AUG 9 200
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.
Hollander, Gene Terms
12692 Charing Cross Road Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8117110 509060 Refund 125.00
Total 125.00
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- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
Hollander, Gene Allowed 20
12692 Charing Cross Road
Carmel, IN 46033
In Sum of
a
125.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1096 -22 509060 4358400 125.00 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
26 -Aug 2010
Signature
125.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund