HomeMy WebLinkAbout157280 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: T360916 Page 1 of 1
ONE CIVIC SQUARE JEFF WEERSMA
CARMEL, INDIANA 46032 1981 E 110TH ST CHECK AMOUNT: $308.26
INDIANAPOLIS IN 46280
CHECK NUMBER: 157280
CHECK DATE: 3/5/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 308.26 PARKS DEPARTMENT REFU
C'
PASS REFUND RECEIPT
Receipt 94313
Payment Date: 02/20/2008 C IVED
Household 5082
Home Phone: (317)581 -1491 2008
Wq,-k Phone: (317)430 -4018 FEB 2
By 3 l c �va
JEFF WEERSMA Monon Center
1981 EAST 110TH STREET Carmel IN 46032
INDIANAPOLIS, IN 46280
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION
Pass Holder: Jeff Weersma Fees +Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #827 0.00 0.00 0.00 0.00 0.00
Valid Dates: 04/15/2007 to 06/30/2008 Pass Cancellation)
Cancel Reason: Transfer to corporate account
CANCELLATION Refund Of 308.26
Pass Holder: Birgit Weersma Fees +Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly HH R (PRMYRHHR), #826 731.74 0.00 731.74 0.00 0.00
Valid Dates: 04/15/2007 to 06/30/2008 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sale Tax Total Fee
Prem Yrly HH Res 731.74 1.00 0.00 0.00 731.74
Cancel Reason: Transfer to corporate account
CANCELLATION
Pass Holder: Daniel Weersma Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #828 0.00 0.00 0.00 0.00 0.00
Valid Dates: 04/15/2007 to 06/30/2008 Pass Cancellation)
Cancel Reason: Transfer to corporate account
CANCELLATION
Pass Holder: Cheryl Weersma Fees +Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #829 0.00 0.00 0.00 0.00 0.00
Valid Dates: 04/15/2007 to 06/30/2008 Pass Cancellation)
Cancel Reason: Transfer to corporate account
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
r Purchase Order No.
Jeff Weersma Terms
1981 E. 110th St. Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/20/08 94313 Refund 308.26
Total 308.26
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.
Jeff Weersma Allowed 20
1981 E. 110th St.
Indianapolis, IN 46280
In Sum of
308.26
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 94313 4358400 308.26 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
28 -Feb 2008
D
Signature
308.26 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund