189977 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 364702 Page 1 of 1
ONE CIVIC SQUARE DEBORAH ROACH CHECK AMOUNT: $38.00
y CARMEL, INDIANA 46032 6109 EAGLES NEST BLVD
o ZIONSVILLE IN 46077 CHECK NUMBER: 189977
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 38.00 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt 511405
Payment Date: 08/23/10
Household 35028
Monon Community Center Deborah Roach Hm Ph: (317)727 -6363
Carmel IN 46032 6109 Eagles Nest Bfvd
Zionsville IN 46077 Cell Ph:
Phone: (317 )848 -7275 juozupaitis @gmail.com
Fed Tax ID #35- 6000972
Refund Details
Orio Bat Refund New Bal
Module: Activity Registration 38.00- 38.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 38.00
Processed on 08/23110 12:11:58 by BJJ NEW REFUND AMOUNT 38.00
TOTAL'REFUNDABLE AMOUNT •38:00:'
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 38.00 Made By REFUND FINAN With Reference
All refunds Ve subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No ash or credit card refunds.
tho Signature Date Authorized Signature Date
ENJOY YOUR ESCAPE!!!
SEP 3 2010
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.
Roach, Deborah Terms
6109 Eagles Nest Blvd Date Due
Zionsville, IN 46077
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/23/10 511405 Refund 38.00
Total 38.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and 1 have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
Roach, Deborah Allowed 20
6109 Eagles Nest Blvd
Zionsville, IN -46077
In Sum of
38.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -42 511405 4358400 38.00 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
13 -Sep 2010
Signature
38.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund