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165039 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: T361998 Page 1 of 1 0 ONE CIVIC SQUARE LISA NELSON CHECK AMOUNT: $60.00 CARMEL, INDIANA 46032 14384 ALLISON DR CARMEL IN 46032 CHECK NUMBER: 165039 CHECK DATE: 10116/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM AMOUN DESCRIPTION 1047 4358400 60.00 PARKS DEPARTMENT REFU J I I I I I ACTIVITY REFUND RECEIPT Receipt 190550 RECIRIVED Payment Date: 09/29/2008 Household 13392 Home Phone: (317)843 -8388 OCT 1 ton Work Phone: BY: LISA NELSON Monon Center 14384 ALLISON DRIVE Carmel IN 46032 CARMEL IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Refund Details Orio Bal Refund New Bal Module: Activity Registration 60.00- 60.00 0.00 G/L Code Description Account Number Cst Cntr Description____________ Accoun Numb Amou 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 60.00 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 60.00 Processed on 09/29/08 11:30:19 by LVA NEW REFUND AMOUNT 60.00 TOTAL REFUNDABLE AMOUNT 60.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 60.00 Made By REFUND FINAN With Reference Ballet 1 low enroll All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issue Nq cash or credit card refunds. Authorized Sig ure Date Authorized Signature Date X 7..3 '3 00, Lq 3 L40o �nro►l E 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. Nelson, Lisa Terms 14384 Allison Drive Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/29/08 190550 Refund 60.00 r, Total 60.00 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 20_ Clerk- Treasurer Voucher No. Warrant No. Nelson, Lisa Allowed 20 14384 Allison Drive Carmel, IN 46032 In Sum of 60.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 190550 4358400 60.00 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 7 -Oct 2008 Signature 60.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund