191584 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 364863 Page 1 of 1
ONE CIVIC SQUARE KELLY CARMODY
CHECK AMOUNT: $184.00
CARMEL, INDIANA 46032 143 CADY CENTRE #201
NORTHVILLE MI 48167 CHECK NUMBER: 191584
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 168.00 PARKS DEPARTMENT REFU
1096 4358400 16.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 532947
Payment Date: 10/25/10
Household 14383
Monon Community Center Kelly Carmody Him Ph: (317)815 -1915
Carmel IN 46032 f �3 9•07MJDT= Road Wk Ph: (317)
�arr�rei�tfb'tj3�'' Cell Ph: (317)260 -0390
kellycarmody1 @att.net
Phone: (317)848- 7275 �((f!l �-1—
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 140.00
Pass Holder: Kelly Carmody Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly (M MCAM), #17744 240.00 0.00 0.00 240.00 0.00
Valid Dates: 12/22/2007 to 12/22/2008 Pass Cancellation)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 10/25/10 13:42:19 by TLP FEES CHANGED ON CANCELLED ITEMS 380.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 240.00
NET AMOUNT FROM CANCELLED ITEMS 140.00
f TOTAL AMOUNT REFUNDED.
L 140.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 140.00 Made By REFUND FINAN With Reference sept cancellation
All refunds are subject to State Board of Accounts
issued, or cre t card refund claim procedure and may take 4 -6 weeks to process. A check will be
�L o
re z-, o
Authorized Signa u Date Aut rized Si alure Date
OCT 2 7 2010
Page 1
PASS REFUND RECEIPT
Receipt 532952
Payment Date: 10/25/10
Household 14383
Monon Community Center Kelly Carmody Hm Ph: (317)815 -1915
Carmel IN 46032 1.0706 Jord'an'Road Wk Ph: (317)
��Jyy�� Carrr►el- IM- 46{32 Cell Ph: (317)260 -0390
kellycarmodyl @att.net
Phone: (317)848 -7276 N j Fed Tax I D #35- 6000972
cal( Z
Pass Details
CANCELLATION Refund Of 28.00
Pass Holder: Ed Carmody Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: FIT Adlt Mnthly (XM FTAM), #91763 212.00 0.00 0.00 212.00 0.00
Valid Dates: 12/26/2009 to 12/26/2010 Pass Cancellation)
Cancel Reason: Moving Out of state.
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 16.00
Processed on 10/25110 13:50:21 by TLP FEES CHANGED ON CANCELLED ITEMS 240.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES 212.00
c NET AMOUNT FROM CANCELLED ITEMS. 28.00•
HH BALANCE APPLIED TO THIS RECEIPT 16.00
TOTAL AMOUNT REFUNDED 44.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 44.00 Made By REFUND FINAN With Reference
All refunds are subject t tate Boar Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue -�ash or cre i card ref
Authorized SignoA6 Date uth rized ignature Dfate
a CU" IRE�
OCT 2 Z 2010
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.
Carmody, Kelly Terms
143 Cady Centre 201 Date Due
Northville, MI 48167
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10125110 432947 Refund 140.00
10/25110 532952 Refund 16.00
10/25/10 532952 Refund 28.00
Total 184.00
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- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
Carmody, Kelly Allowed 20
143 Cady Centre 201
Northville, Ml 48167
In Sum of
184.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 432947 4358400 140.00 1 hereby certify that the attached invoice(s), or
109641 532952 4358400 16.00 bill(s) is (are) true and correct and that the
1092 532952 4358400 28.00 materials or services itemized thereon for
which charge is made were ordered and
received except
4 -Nov 2010
Signature
184.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund