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165140 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: T362036 Page 1 of 1 t ONE CIVIC SQUARE SHERRY BEVERLY I€ Q CHECK AMOUNT: $58.00 CARMEL, INDIANA 46032 7208 REBECCA SE ALBURNwA 98092 CHECK NUMBER: 165140 CHECK DATE: 10129/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 191720 58.00 REFUNDS AWARDS INDE F a�= GLOBAL REFUND RECEIPT C [OCT Receipt 191720 Payment Date: 10/03/2008 2 2 2008 Household 4600 Home Phone: (317)733 -1497 Work Phone: (317)733 -1497 BY: SHERRY BEVERLEY Monon Center -710�F b&W Carmel IN 46032 !m cynt�ngv Qg O��' Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Refund Details Oria Bal Refund New Bal Module: Activity Registration 58.00- 58.00 0.00 GIL Code Descri Account Number Cst Cntr Descri Accoun Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 58.00 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 CREDIT HOUSEHOLD BALANCE 58.00 Processed on 10/03108 10:14:59 by EMB NEW REFUND AMOUNT 58.00 "TOTAL REFUNDABLE r NEW NET HOUSEHOLD BALANCE 0.00 Refund of 58.00 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. A check will be issued. No cash or credit card refunds. �-?u L Authorize Signature Date Authorized Signature Date H 2�DO �00 �:�S7HOO UV d c 1 T "�v`'"" U ��.,vl J V Lc o I.a t (c (t `l�l .:f 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. Beverly, Sherry Terms 7208 Rebecca SE Date Due Alburn, WA 98092 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/3/08 191720 Refund 58.00 Total 58.00 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. Beverly, Sherry Allowed 20 7208 Rebecca SE Alburn, WA 98092 I n Sum of I 58.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT#ITITLE AMOUNT Board Members Dept 1047 191720 4358400 58.00 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 22 -Oct 2008 "al Signature 58.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund