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165358 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: T362057 Page 1 of 1 ONE CIVIC SQUARE VICKI NEWLIN CHECK AMOUNT: $140.00 CARMEL, INDIANA 46032 11418 W CENTRAL DR CARMEL IN 46032 CHECK NUMBER: .165358 CHECK DATE: 10/29/2008 DEPARTMENT AC COUN T PO NUMBER INVOICE NUMBER AM DESCRIPTION 1047 4358400 190839 140.00 REFUNDS AWARDS INDE I I i G EIVE O C i 1 4 2008 Motion Center ;;Y: Clerk: ARH Date: 09/30/2008 H /fl: Vicki Newlin F /M: Vicki Newlin Description Fxt Price Below Pass Is The Result Of A Transfer Pass 0 Type 240.00 Prem. Yrly Sr R From 09/30/2008 05/31/2009 Rcpt# 190839 Prev Bal: 0.00 New Charges 140.00 New Tax: 0.00 Total Due: 140.00 Tot Refund: 140.00 New Bal: 0.00 Ref and Type: Refund from f=inance REFUND FINAN Refund of: 140.00 Payment. of 240.00 Made By Pass Mgt Credit Balance 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 rash or credit card refunds. Authorized Signature Date r1 l „s,,,k 'J A- s J Authorized Signature Date yy� LZr 19039 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. Newlin, Vicki Terms 11418 W Central Dr Date Due Carmel, IN 46032 J Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/30/08 190839 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. Newlin, Vicki Allowed 20 11418 W Central Dr Carmel, IN 46032 In Sum of 140.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or Board Members Dept INVOICE NO. ACCT #/TITLE AMOUNT 1047 190839 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 14 -Oct 2008 Signature 140.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund i