HomeMy WebLinkAbout195406 03/16/2011 „wf CITY OF CARMEL, INDIANA VENDOR: 365165 Page 1 of 1
J ONE CIVIC SQUARE MEENA ELLIOTT CHECK AMOUNT: $13.50
+,a CARMEL, INDIANA 46032 1728 BEALIFAIN STREET
CARMEL IN 46032 CHECK NUMBER: 195406
CHECK DATE: 3/16/2011
DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 13.50 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 585811
Payment Date: 03/09/11
Household 1986
Monon Community Center Meena Elliott Him Ph: (317)587 -1922
Carmel IN 46032 1728 Beaufain St
Carmel IN 46032 Cell Ph:
michael.elliott@duke.edu
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION
Pass Holder: Meena Elliott Fees Tax Discount Prev Paid Our Paid Amount Due
Pass Type: KZ 50 Visit (M Z50), #14920 61.50 0 "00 61.50 0.00 0.00
Valid Dates: 09/29/2007 to 12/31/2099 Pass Cancellation)
Pass Visit info: Number of Visits: 9
Cancel Reason: prorated request
The following item reflects a payment towards a previous receipt
Pass Holder: Maya Elliott Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Swim Less P 10 (M SWMPRV), #63086 200.00 0.00 105.00 13.50 81.50
Valid Dates: 04/10/2009 to 04/15/2099 Pass Change)
Pass visit Info: Number of Visits: 10
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 03/09/11 C 12:59:16 by LVA FEES CHANGED ON CANCELLED ITEMS 13.50
-NET- :AMOUNT FROM CANCELLED ITEMS 13:50-
FEES ADJUSTED ON CHANGED ITEMS 0.00
NET AMOUNT FROM CHANGED ITEMS 0:00
TOTAL AMOUNT REFUNDED.13.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 13.50 Made By REFUND FINAN With Reference prorated request
Payment of 13.50 Made By Pass Management Credit Balance
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.
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Authorized S" ature D to Authoriz 5igmtur 'Date ;/�Y 7
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N O W MCC, Qa�35 MAR
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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.
Elliott, Meena Terms
1728 Beaufain St Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
319111 585811 Refund 13.50
Total 13,50
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Elliott, Meena Allowed 20
1728 Beaufain St
Carmel, IN 46032
In Sum of
13.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -41 585811 4358400 13.50 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
�yC�% ✓�Z�2�h�
Signature
13.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund