190521 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364748 Page 1 of 1
ONE CIVIC SQUARE PATRICIA WIGGINS
CARMEL, INDIANA 46032 53 GRANITE DRIVE CHECK AMOUNT: $35.00
CARMEL IN 46032
CHECK NUMBER: 190521
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUN D ESCRIPTION
1092 4358400 35.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 522679
Payment Date: 09/17/10
Household 16722
Monon Community Center Patricia Wiggins Hm Ph: (317)843 -9142
Carmel IN 46032 53 Granite Drive Wk Ph: (317)846 -5554
Carmel IN 46032 Cell Ph: (317)590 -9042
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 35.00
Pass Holder: Calvin White Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type. MC Adlt Mthly (M MCAM), #108283 90.00 0.00 0.00 90.00 0.00
Valid Dates: 05131/2010 to 05/31/2011 Pass Cancellation)
Cancel Reason: ancellation should have been on 8/23/10.
PREVIOUS NET HOUSEHOLD BALANCE 15.00
Processed on 09/17/10 14:08:59 by TLP FEES CHANGED ON CANCELLED ITEMS 140.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 90.00
NET AMOUNT FROM CANCELLED ITEMS 50.00
HH BALANCE APPLIED TO THIS RECEIPT 15.00
TOTAL AMOUNT REFUNDED 35.00
J NEW NET HOUSEHOLD BALANCE 0.00
Refund of 35.00 Made By REFUND FINAN With Reference check
All refunds are subject to of A n�Ys claim procedure and may take 4 -6 weeks to process. A check will be
issued. No _cash credit nds.
rized Signatures Date Authorized Signature Date
The Monon Community Center is a one -stop shop! Why drive all day searching for your local garage sale? Come to our
Community Garage Sale and leisurely browse through all sorts of items. The Community Garage Sale will take place Saturday,
October 9 from 10am -4pm at the MCC East Parking Lot. The event is free to the public.
Vendors: The fee for vendors is $5 /parking space. You must bring a table /chair. A limited number of tables and chairs will be
available at an additional cost of $5 each. In case of inclement weather, this event will be cancelled. To register, please
contact Sarah or fax your form to 317.573.5243.
To 4 v" J 71 W
S EP 7010
BY:
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.
Wiggins, Patricia Terms
53 Granite Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9117110 522679 Refund 35.00
Total 35.00
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.
Wiggins, Patricia Allowed 20
53 Granite Drive
Carmel, IN 46032
In Sum of
35.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 522679 4358400 35.00 E 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
U
Signature
35.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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