HomeMy WebLinkAbout193401 01/05/2011 CITY OF CARMEL, INDIANA VENDOR: T0002496 Page 1 of 1
ONE CIVIC SQUARE CORTNEY COLLINS CHECK AMOUNT: $52.00
CARMEL, INDIANA 46032 3048 BAYBERRY CT E
CARMEL IN 46033 CHECK NUMBER: 193401
CHECK DATE: 1/5/2011
DEPARTMENT ACCOUNT P NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 52.00 REFUNDS AWARDS INDE
GLOBAL REFUND RECEIPT
Receipt 546079
Payment Date: 12/07/10
Household 36322
Monon Community Center cortney Collins Hm Ph: (317 )610 -7170
Carmel IN 46032 3048 bayberry ct e.
carmel in 46033 Cell Ph:
Phone: (317 )848 -7275 cortney.collins@defenderdirect.com
Fed Tax I D #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 52.00- 52.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 52.00
Processed on 12/07/10 15:58:43 by BJJ NEW REFUND AMOUNT 52.00
TOTAL AMOUNT 52:00':
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 52.00 Made By REFUND FINAN With Reference
l C
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. o cash or credit card refunds.
0-�-10
ut 'ed Signature Date Authorized Signature Date
St
1 0 JAN 0 3 2011
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Page 1
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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,
Collins, Cortney Terms
3048 Bayberry Ct E Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1217111 546079 Refund 52.00
Total 52.00
1 hereby certify that the attached invoice(s), or bills) 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.
Collins, Cortney Allowed 20
3048 Bayberry Ct E
Carmel, IN 46033
In Sum of
i
52.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #(TITLE AMOUNT Board Members
Dept
1081 11 546079 4358400 52.00 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
3 -Jan 2011
Vh
Signature
52.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund