164722 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: T361992 Page 1 of 1
ONE CIVIC SQUARE NABIL GHALAYINI
y� CARMEL, INDIANA 46032 14401 CHARIOTS WHISPER DR CHECK AMOUNT: $174.00
WESTFIELD IN 46074 CHECK NUMBER: 164722
CHECK DATE: 10/16/2008
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM OUNT DE SCRIPTION
1047 435,8400 174.00 ''PARKS DEPARTMENT REFU
e<
t
't ACTIVITY REFUND RECEIPT
ID
Receipt 190257
Payment Date: 09/26/2008 0 08
Household 20975
Home Phone: (317)844 -8634
Work Phon e: (317)
NABIL GHALAYINI Monon Center
14401 CHARIOTS WHISPER DR. Carmel IN 46032
WESTFIELD IN 46074
Phone: (317)848-7275
Fed Tax ID #35-6)00972
Refund Details
Q rig Bal Refund New Bal
Module: Activity Registration 174.00- 174.00 0.00
G/L Code Description Account Number Cst Cntr Descri Acc ount Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 174.00 DR
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written tc the customers.
PREVIOUS NET HOUSEHOLD BALANCE 174.00
Processed on 09/26/08 08:56:59 by ALC NEW REFUND AMOUNT 174.00
TOTAL REFUNDABLE AMOUNT '174.00
NEW NET HOUSEHOLD BALANCE 0.00
1
Refund of 174.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks t process. A check will be
i ued. No cash or cr it carp refunds.
h u Date Authorized Signature Date
i 3
3Y3 �l �OD
Page 1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates servic rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Ghalayini, Nabil Terms
14401 Chariots Whisper Dr. Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/26/08 190257 Refund 174.00
Total 174.00
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.
Ghalayini, Nabil Allowed 20
14401 Chariots Whisper Dr.
Westfield, IN 46074
In Sum of
174.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 190257 4358400 174.00 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
6 -Oct 2008
Signature
174.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund