190266 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364735 Page 1 of 1
ONE CIVIC SQUARE NANCY GAGEN
CARMEL, INDIANA 46032 13776 ROSWELL DRIVE CHECK AMOUNT: $336.00
CARMEL IN 46032
o CHECK NUMBER: 190266
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 336.00 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt 519798
Payment Date: 09/14/10
Household 26036
Monon Community Center Nancy Gagen Hm Ph: (317)569 -1601
Carmel IN 46032 13776 Roswell Drive Wk Ph: (317)805 -9820
Carmel IN 46032 Cell Ph:
nancy.gagen @rci.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bat Refund New Bat
Module: Activity Registration 336.00 336.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 336.00
Processed on 09/14/10 14:41:52 by BJJ NEW REFUND AMOUNT 336.00
TOTAL',REI=UNDABLE AMOUNT 336:00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 336.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. o cash or credit card refunds.
uthoriz ig Date Authorized Signature Date
Register today for Family Campout at www.carmelclayparks.com!
Friday- Saturday, September 24 -25 from 4:30pm -9am
Fee is $40/family
West Park, 2700 W 116th Street
10RR
SEA' 1 6 2010
D 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.
Gagen, Nancy Terms
13776 Roswell Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9114110 519798 Refund 336.00
Total 336.00
1 hereby certify that the attached invoices). 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,
Gagen, Nancy Allowed 20
13776 Roswell Drive
Carmel, IN 46032
In Sum of
336.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -1 519798 4358400 336.00 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
23 -Sep 2010
Signature
336.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund