HomeMy WebLinkAbout192136 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 364878 Page 1 of 1
ONE CIVIC SQUARE SHELIA JOHNSON CHECK AMOUNT: $217.00
,o CARMEL. INDIANA 46032 13200 GRIFFIN RUN
CARMEN 1N 46033 CHECK NUMBER: 192136
CHECK DATE: 11/2312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 217.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 536315
Payment Date: 11/09/10
Household 4505
Monon Community Center Sheila Johnson Hm Ph: (317)574 -0034
Carmel IN 46032 13200 Griffin Run Wk Ph: (317)
Carmel IN 46033 Cell Ph: (317)514 -5356
3sonsrgr8@sbcglobal.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
PREVIOUS NET HOUSEHOLD BALANCE 222.00
Processed on 11/09/10 09:28:25 by JAB NEW REFUND AMOUNT (I 222.00
TOTAL REFUNDABLE AMOUNT
NEW NET CREDIT HOUSEHOLD BALANCE 5.00
Refund of 217.00 Made By REFUND FINAN With Reference check refund
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credi card refunds.
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or14d Signature Date Authorized Signature Date
b�9 U 2010
1 ]B Yo
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.
Johnson, Sheila Terms
13200 Griffin Run Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1119110 536315 Refund 217.00
Total 217.00
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
1 20
Clerk- Treasurer
Voucher No, Warrant No.
Johnson, Sheila Allowed 20
13200 Griffin Run
Carmel, IN 46033
In Sum of
217.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -7 536315 4358400 217.00 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
217.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund