HomeMy WebLinkAbout195017 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 365139 Page 1 of 1
0 Ei ONE CIVIC SQUARE MICHELLE DORN CHECK AMOUNT: $112.00
CARMEL, INDIANA 46032 3578 FOSTER RIDGE LANE
CARMEL IN 46033 CHECK NUMBER: 195017
CHECK DATE: 3/2/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 112.00 REFUND
GLOBAL REFUND RECEIPT
Receipt 574876
Payment Date: 02/14/11
Household 1602
Morton Community Center Michelle Dorn Hm Ph: (317)776 -1695
Carmel IN 46032 3578 Foster Ridge Lane
Carmel IN 46033 Cell Ph:
mdorn @indy.rr.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Orio Bal Refund New Bal
Module: Pass Management 112.00- 112.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 112.00
Processed on 02114/11 10:03:25 by BJJ NEW REFUND AMOUNT 112.00
TOTALiRE FUN DABLE'AMOU NTT
112Q0
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 112.00 Made By REFUND FINAN With Reference
All refu s 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.
l/
Aut�ignature Date Authorized Signature Date
Sign up now or volunteer for our Dime Carnival taking place on March 5, from 6 -9pm in the MCC Banquet Rooms. There will
be at least 15 different types of games appropriate for ages 3 -12 years old. The number of tickets required to play varies for
each game. You may play your favorite game as often as you would like; just make sure you don't run out of tickets. Tickets
are 10 cents each, put you may purchase by the dollar. Visit carmelclayparks.com for ticket numbers and pricing.
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5 FEB 14 2011
BY:
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.
Dorn, Michelle Terms
3578 Foster Ridge Lane Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/14111 574876 Refund 112.00
Total 112.00
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
20_
Clerk- Treasurer
Voucher No, Warrant No,
Dorn, Michelle Allowed 20
3578 Foster Ridge Lane
Carmel, IN 46033
In Sum of
112.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -2 574876 4358400 112.00 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
24 -Feb 2011
o
i
Signature
112.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund