HomeMy WebLinkAbout195404 03/16/2011 ,f CITY OF CARMEL, INDIANA VENDOR: 365163 Page 1 of 1
ONE CIVIC SQUARE BETHANIE EDWARDS -GOFF
CARMEL, INDIANA 46032 4926 BRIARW00D TRAIL CHECK AMOUNT: $24.00
CARMEL IN 46033
CHECK NUMBER: 195404
CHECK DATE: 3!1612011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 24.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 583571
Payment Date: 03/03/11
Household 7716
Monon Community Center Bethanie Edwards -Goff Hm Ph: (317)566 -8826
Carmel IN 46032 4926 Briarwood Trail Wk Ph: (317)796 -8563
Carmel IN 46033 Cell Ph: (317)625 -2395
jg@gotranspay.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 24.00
Pass Holder: Bethanie Edwards Goff Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: KZ 10 Visit (M Z10), #16464 16.00 0.00 16.00 0.00 0.00
Valid Dates: 04/16/2009 to 12/31/2099 Pass Cancellation)
Pass Visit Info: Number of Visits: 6
Cancel Reason: prorated request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 03/03/11 10:21:01 by LVA FEES CHANGED ON CANCELLED ITEMS 24.00
r "NET AMOUNT- FROMCANCEILED ITEMS 24.40-
TOTAL`AMOUNT'REFUNDED' =.24.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 24.00 Made By REFUND FINAN With Reference 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
issued. No cash or credit card refunds.
3 I
A�� A,th,riwd Sigm re D& All ed Sign ure 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 �bsy1 the dollar. Visit carmelclayparks.com for ticket numbers and pricing.
B Y........................
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,
Edwards -Goff, Bethanie Terms
4926 Briarwood Trail Date Due
Carmel, I N 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3!3111 583571 Refund 24.00
Total 24.00
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.
Edwards -Goff, Bethanie Allowed 20
4926 Briarwood Trail
Carmel, IN 46033
In Sum of
24.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
109642 583571 4358400 24.00 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
10-Mar 2011
Signature
24.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund