189769 09/14/2010 a CITY OF CARMEL, INDIANA VENDOR: 364697 Page 1 of 1
ONE CIVIC SQUARE BRYCE ESPEY CHECK AMOUNT: $56.00
CARMEL, INDIANA 46032 12030 CASTLE ROW OVERLOOK
CARMEL IN 46033 CHECK NUMBER: 189769
CHECK DATE: 9/1412010
DEPARTMENT ACC P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 56.00 PARKS DEPARTMENT REFU
,r:
PASS REFUND RECEIPT
Receipt 514845
Payment Date: 08/31/10
T O R Y Mig Household 32303
:,C,- 0 1 ZOiO
Carmel Clay Parks Recreation Bryce Espey Hm Ph: (317)502 -3095
1235 Central Park Drive East B%,• 12030 Castle Row Overlook
Carmel IN 46032 Carmel IN 46033 Cell Ph:
Phone: (317)$48 -7275 aeespey @indiana.edu
Fed Tax I D #35- 6000972
Pass Details
MEMBERSHIP CHANGE Refund Of 28.00
Pass Holder: Bryce Espey Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: FIT Adlt Mnthly (XM FTAM), #110007 56.00 0.00 56.00 0.00 0.00
Valid Dates: 06/15/2010 to 01/14/2011 Pass Cancellation)
MEMBERSHIP CHANGE Refund Of 28.00
Pass Holder: Adrian Espey Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: FIT Adlt Mnthly (XM FTAM), #107505 56.00 0.00 56.00 0.00 0.00
Valid Dates: 05/25/2010 to 01/14/2011 Pass Cancellation)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/31/10 16:27:16 by ABK FEES ADJUSTED ON CHANGED ITEMS 56.00
NET'AMOUNT-:FROM 'CHANGED ITEMS
TOTAL,AMOUNT REFUNDED 56.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 500 Made By REFUND FINAN With Reference per SBeaurain
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check w ill be
issued. No cash or credit card refunds.
Authori "ed Signatu Date Authorized Signature Date
Don't forget to register for St.Vincent Tour de Carmel taking place on Saturday, September 11. Visit
www.carmelclayparks.corn for more information or https:Hrec.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 -fpm, or September 9 from 5 -8pm.
10%
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.
Espey, Bryce Terms
12030 Castle Row Overlook Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8131/10 514845 Refund 56.00
Total 56.00
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- 16 -1_6
20_
Clerk- Treasurer
Voucher No. Warrant No.
Espey, Bryce Allowed 20
12030 Castle Row Overlook
Carmel, IN 46033
In Sum of
56.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #fTITLE AMOUNT Board Members
Dept
1096 -21 514845 4358400 56.00 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
56.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund