192162 11/23/2010 4, CITY OF CARMEL, INDIANA VENDOR: 364880 Page 1 of 1
ONE CIVIC SQUARE BARB MARSHALL
CARMEL, INDIANA 46032 13215 MATTOCK CHASE CHECK AMOUNT: $175.00
CARMEL IN 46033
CHECK NUMBER: 192162
CHECK DATE: 11/2312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 175.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 537766
Payment Date: 11/12/10
Household 8618
Monon Community Center Barb Marshall Hm Ph: (317)706 -1575
Carmel IN 46032 13215 Mattock Chase Wk Ph: (317)
Carmel IN 46033 Cell Ph: (317)797 -8810
barbbmarshatl @aol.com
Phone: (317)848-7275
Fed Tax ID #35- 6000972
Pass Details
MEMBERSHIP CHANGE Refund Of 175.00
Pass Holder: Barb Marshall Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly (M MCAM), #19492 70.00 0.00 70.00 0.00 0.00
Valid Dates: 01104/2010 to 01/26/2011 Pass Cancellation)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 11112/10 15:17:56 by TLP FEES ADJUSTED ON CHANGED ITEMS 175.00-
NET AMOUNT FROM CHANGED ITEMS 175.00
J TOTAL AMOUNT REFUNDED 175.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 175.00 Made By REFUND FINAN With Reference
All refunds are subject to State Boa�rd Accounts claim procedAan V4w ks to process. A check will be
issued cash or, dit c r refunds.
Authorized ignature Date Ay! o ign re Date
N OV 1 5 2010 El
BY:.......................
Page 4 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.
Marshall, Barb Terms
13215 Mattock Chase Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11112/10 537766 Refund 175.00
Total 175.00
k 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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Marshall, Barb Allowed 20
13215 Mattock Chase
Carmel, IN 46033
In Sum of
175.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 537766 4358400 175.00 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
18 -Nov 2010
U
Signature
175.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund