HomeMy WebLinkAbout192674 12/10/2010 CITY OF CARMEL, INDIANA VENDOR: 364929 Page 1 of 1
0 *f ONE CIVIC SQUARE KRISTA LEBLANC CHECK AMOUNT: $140.00
CARMEL, INDIANA 46032 905 JUNCTION PLACE
INDIANAPOLIS IN 46220
CHECK NUMBER: 192674
CHECK DATE: 12/1012010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 140.00 REFUND
PASS REFUND RECEIPT
Receipt 545586
Payment Date: 12/06/10
Household #f: 29135
Monon Community Center Krista Leblanc Hm Ph: (501)831 -9115
Carmel IN 46032 905 Junction Place Wk Ph: (317)
Indianapolis IN 46220 Cell Ph:
Phone: (317)848 -7275
kristalebtanc @yahoo. cam
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 35.00
Pass Helder: Krista Leblanc Fees Tax Discoun Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly (M MCAM), #94646 35.00 0.00 0.00 35.00 0.00
Valid Dates: 07/16/2010 to 07/29/2011 Pass Cancellation)
Cancel Reason: called in late August to cancel. had moved to Lafayette LA in Auguest 2010
CANCELLATION Refund Of 105.00
Pass Holder: Robby Leblanc E m Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly (M MCAM), #94647 35.00 0.00 0.00 35.00 0.00
Valid Dates: 07/16/2010 to 07/29/2011 Pass Cancellation)
Cancel Reason: called in late August to cancel. had moved to Lafayette LA in Auguest 2010
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 12/06/10 15:32:17 by TLP FEES CHANGED ON CANCELLED ITEMS 210.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 70.00
NET AMOUNT FROM CANCELLED ITEMS 140.00
f) TOTAL AMOUNT REFUNDED 140.00
L 1 �L} L3�5WbV NEW NET HOUSEHOLD BALANCE 0.00
Refund of 14 0.00 Made By REFUND FINAN With Reference sept&ocL billing
All refun a sub c{� Slate /l�' off Accounts claim procedure and may take ee s to rocess. A check will be
iss o cash or cred't car r s.
Authorized Sign, Date Au o ed Signa a Date
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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.
Leblanc, Krista Terms
905 Junction Place Date Due
Indianapolis, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1216110 545586 Refund 140.00
Total 140.00
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.
Leblanc, Krista Allowed 20
905 Junction Place
Indianapolis, IN 46220
In Sum of
140.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #f AMOUNT Board Members
Dept
1092 545586 4358400 140.00 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
9 -Dec 2010
r �C'�2LI/l7'!/IylL
Signature
140.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund