HomeMy WebLinkAbout155282 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360698 Page 1 of 1
ONE CIVIC SQUARE MARK ENSOR
CHECK AMOUNT: $140.00
1033 SEDONA PASS
CARMEL, INDIANA 46032 INDPLS IN 46280 CHECK NUMBER: 155282
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 79071 140.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 79071
Payment Date: 12/22/2007
Household 14178
Home Phone: (317)362 -3744
Work Phone: JAN 0 3 200
h, PIS
MARK ENSOR Monon Center
1033 SEDONA PASS Carmel IN 46032.
INDIANAPOLIS, IN 46280
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
Pass Holder: Mark Ensor Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #17705 240.00 0.00 240.00 0.00 0.00
Valid Dates: 12/15/2007 to 1 2/1 5120 08 Pass Transfer from Prem. Yrly Ad R)
Fee Details: Fee De Amount Count Discount S ales Tax Total Fee
Yearly Fitness Adult 240.00 1.00 0.00 0.00 240.00
GIL Code Description Account Number C st Cntr Des cription Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 140.00 DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
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 0.00
Processed on 12/22/07 08:13:51 by EDR NET FROM/TO TRANSFER FEES 140.00
DISCOUNT APPLIED AGAINST THESE FEES 0.00
NET FROMITO TRANSFER TAX 0.00
f- NET AMOUNT "F;ROM�Cl-1;4R'GEt;�ITEMS,_.:r °;',:1.40 QO,�
nTOTALzAMQUNT REFUNDED,_r ,t,u
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance
Refund of 140.00 Made By JOURNAL -RF With Reference
Amount: 240.00 Payment Type: Pass Management Credit Balance
All refunds are su ct to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No ca or cr dit card refunds.
Authori .ed ignature Date Authorized Signature Date
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.
Mark Ensor Terms
1033 Sedona Pass Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/22/07 79071 Refund 140.00
Total 140.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Mark Ensor Allowed 20
1033 Sedona Pass
Indianapolis, IN 46280
In Sum of
140.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1047 79071 4358400 140.00 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
4 -Jan 2008
Sig ature
140.00 Busine Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund