HomeMy WebLinkAbout189505 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: T358671 Page 1 of 1
ONE CIVIC SQUARE JAYDENE SHAIKHADEH
j CARMEL, INDIANA 46032 1411 PLANTATION WOOD LANE CHECK AMOUNT: $276.00
CARMEL IN 46033 CHECK NUMBER: 189505
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 276.00 REFUNDS AWARDS INDE
r
000509877
Carmel Elementary Clerk: 7CM
Date: 08/19/2010 Time: 15:09:09
H /H J aydene Shai khadeh A
F /M: Roxanne shai khadeh
Description Ext Price
elow Pass I s The Result Of A Transfer
Pas Type
4 -5 wee
From 08/10/2010 08/13/2010
lice
F /M: Maxine shai khadeh AUG ?Q�
Description Ext Price
��e.,
Below Pass Is The Result Of A Transfer
Pass 0 Type
4 5 7 Week 1 PM
From 08/10/2010 08/13/2010
RCpt# 509877 Prev Bal: 0.00
New Charges 276.00
New Tax: 0.00
Total Due: 276.00
Tot Refund: 276.00 17 J�
O�� 1
New Bal: 0.00
Ref!! types Refund from Finance
UND FINA Refund of: 276.00
payment of 108.00
Made By Pass Mgt Credit Balance
All refunds are subject to state Board
of Accounts claim procedure d may take
4 -6 weeks to process. A ec ill be
issue No cash or credit card refunds.
th ized signature Date
Authorized Signature Date
TEST
Fed Tax ID #35- 6000972
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.
Shaikhadeh, Jaydene Terms
14111 Plantation Wood Ln Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8!19110 509877 Refund 276.00
Total 276.00
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.
Shaikhadeh, Jaydene Allowed 20
14111 Plantation Wood Ln
Carmel, IN 46033
In Sum of
276.00
ON ACCOUNT OF APPROPRIATION FOR
108 —ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -1 509877 4358400 276.00 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
276.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund