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163609 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: T361814 Page 1 of 1 ONE CIVIC SQUARE ANGELA ARLINGTON s CHECK AMOUNT: $105.00 CARMEL, INDIANA 46032 459 FILMORE DRIVE WESTFIELD IN 46074 CHECK NUMBER: 163609 CHECK DATE: 9/17/2008 DEPARTMENT ACC OUNT PO NUMBER INVOICE NUMBER AMOUNT DESC 1047 4358400 185147 105.00 REFUNDS AWARDS INDE 1 I ACTIVITY REFUND RECEIPT Receipt 185147 Payment Date: 09/02/2008 Household 5165 Home Phone: (317)867 -5429 Work Phone: C V -r D SEP 0 8 2008 ANGELA ARLINGTON Monon Center BY 459 FILMORE DRIVE Carmel IN 46032 WESTFIELD IN 46074 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Refund Details LXLX) y0uJ Orio Bal Refund New Bal Module: Activity Registration 105.00- 105.00 0.00 G /LCod.e Description AccountNumber_ Cst_Cntr Description Account_ Number__ Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 105.00 DR Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers. PREVIOUS NET HOUSEHOLD BALANCE 105.00 Processed on 09/02/08 17:39:03 by LVA NEW REFUND AMOUNT 105.00 TOTAL REFUNDABLE AMOUNT 105.00 NEW NET HOUSEHOLD BALANCE 0.00 I t Refund of 105.00 Made By REFUND FINAN With Reference All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. check All be issu d. No cash or credit card refunds. 0&4- Pow o Authorized i nature ate Authorized Signature Date 7.3(.00 �00 q5�� d0 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. Arlington, Angela Terms 459 Filmore Drive Date Due Westfield, IN 46074 Invoice Invoice Description Date Number or note attached invoice(s) or bill(s)) Amount 105.00 9/2/08 185147 Refund Total 105.00 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 1 20 Clerk- Treasurer Voucher No. Warrant No. Arlington, Angela Allowed 20 459 Filmore Drive Westfield, IN 46074 In Sum of 105.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 185147 4358400 105.00 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 -Sep 2008 Signature 105.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund