189748 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 364696 Page 1 of 1
6 ONE CIVIC SQUARE BRAD DAVIDSON
CARMEL, INDIANA 46032 1337 ASHVILkE DRIVE CHECK AMOUNT: $95.00
WESTFIELD IN 46074 CHECK NUMBER: 189748
CHECK DATE: 9/1412010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 95.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 515672
Payment Date: 09/03/10
Household 36000
Monon Community Center Brad Davidson Hm Ph: (317)669 -7450
Carmel IN 46032 1337 Ashville Drive Wk Ph: (317)706 -2635
Westfield IN 46074 Cell Ph: (317)501 -8492
Phone: (317)848 -7275
Fed Tax ID 435- 6000972
Pass Details
MEMBERSHIP CHANGE Refund Of 95.00
Pass Holder: Brad Davidson Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC HH Mthly (M MCHHM), #110956 95.00 0.00 95.00 0.00 0.00
Valid Dates: 06/27/2010 to 06/27/2011 Pass Cancellation)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/03/10 15:40:20 by TLP FEES ADJUSTED ON CHANGED ITEMS 95.00
NET AMOUNT FROM CHANGED ITEMS 95.00
TOTAL AMOUNT REFUNDED 95.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 95.00 Made By RF_F D FiNAN With Reference
All refunds are surcdi o State o r of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue cash t car f n
Authorized Sig ature Date Authorized Signature Date i
Don't forget to register for St.Vincent Tour de Carmel taking place on Saturday, September 11. Visit
www.carmelciayparks.com for more information or https: /rec.themononcenter.com/ to register!
If you have already registered for the event, you may pick up your goodie bag at the MCC East Building on September 7 from
5 -8pm, September 8 from 9am -1 pm, or September 9 from 5 -8pm.
7
]BY
Page 9 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,
Davidson, Brad Terms
1337 Ashville Drive Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
913110 51672 Refund 95.00
Total 95.00
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.F
20�
Clerk- Treasurer
i
Voucher No. Warrant No.
Davidson, Brad Allowed 20
1337 Ashville Drive
Westfield, IN 46074
In Sum of
95.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1092 51672 4358400 95.00 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
9 -Sep 2010
Signature
95.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund