HomeMy WebLinkAbout192834 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 364938 Page 1 of 1
ONE CIVIC SQUARE JIM HESTER
CARMEL, INDIANA 46032 16464 CYPRIAN CIRCLE CHECK AMOUNT: $75.00
WESTFIELD IN 46074
CHECK NUMBER: 192834
CHECK DATE: 12/15/2010
DEPARTMENT ACCO PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4356400 546296 75.00 REFUND
PASS REFUND RECEIPT
Receipt 546296
Payment Date: 12/08/10
Household 7282
Monon Community Center Jim Hester C�fck,,Q- Hm Ph: (317)804 -9796
Carmel IN 46032 16464 Cyprian V. Wk Ph: (317)844 -9113
Westfield IN 46074 Cell Ph:
the_Hesters@comcast.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 75.00- 75.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 75.00
Processed on 12/08/10 13:28:41 by LVA NEW REFUND AMOUNT 75.00
TOTAL REFUNDABLE AMOUNT 75:00'
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 75.00 Made By REFUND FINAN With Reterence prorated request
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue No cash or credit card refunds.
Authorized Sig ure Date Au o ed 5ig ure Date
9 2 010 L
Page 9 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.
Hester, Jim Terms
16464 Cyprian Circle Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/8/10 546296 Refund 75.00
Total 75.00
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.
Hester, Jim Allowed 20
16464 Cyprian Circle
Westfield, IN 46074
In Sum of
75.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
109641 546296 4358400 75.00 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
Signature
75.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund