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155457 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00351721 Page 1. of 1 ONE CIVIC SQUARE JAMES PAGE CHECK AMOUNT: $1,334.00 CARMEL, INDIANA 46032 CHECK NUMBER: 155457 CHECK DATE: 1/10/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION k' 1202 4128000 1,334.00 TUITION REIMBURSEMENT i J Martin University 12/20/07 01:50 pm Billing Combination Schedule and Statement RT1� NlVLR��� \j Page, James E Student ID: 404 -78 -3334 3961 N Broadway College Level: Masters Indianapolis, IN 46205 Advisor: SITYNE, O'NEAL Degree Program: URBAN MINISTRY STUDIES Registration Term: FA -07 1 UMS -510 -50 Research Foundations for Urb Min/ INTENSIVE Sept. 4th -14t 3.0 A 9/4/2007 9/22/2007 Instructor: SITYNE, O'NEAL M 6:00 PM 8:50 PM Hourly Fee: $0.00 Lab Fee T 6:00 PM 8:50 PM W 6:00 PM 8:50 PM R 6:00 PM 8:50 PM F 6:00 PM 8:50 PM Total Credits:3.0 Previous Balance $0.00 8/23/2007 FA -07 Charged Tuition FA -07 $1,320.00 8/24/2007 FA -07 Computer Lab Usage $30.00 8/24/2007 FA -07 Student Activity $30.00 8/24/2007 FA -07 Safety and Public Service $100.00 12/14x'20071 FA -07 I Tuition Payment Charge $1,480.00 Please Remit Payment To: Total 0.00 Martin University Attn: Bursar Office 2171 Avondale Place Indianapolis, IN 46218 Previous Balance 0.00 Overall Balance $0.00 i QTY: CLASS DESCRI •PRICE �iAM01lN'f 1 C 11A fil Dt�l O I Ot L� a O Uj V! JY w2 DATE1 TJ' l AUTHORIZATION TOTAL tJ�J y 0 SUB j N REFERENCE N O. SERVER TAX ID FOL10 /CHECK NOAIC. NO. STATE REGJDEPT., CLERK TIP r SIGN HERE misc. i 1 M x ;�1r�,1�►,� 5320198 The bluer of the eardMenffW on this Rom to a yNhoAzed(ro pee�yelM artauiH'ehown�aas�ToOTAL nt� wlMthee Qre T emer�rtprwemUg r use� o wCtcard. ads CUSTOMER: RETAIN THIS COPY FOR YOUR RECORDS Martin University 12/14/07 05:26 pm 2171 Avondale Place nAM4 Indianapolis, IN 46218 317- 543 -3235 UN 11RTV�' Billing Statement VERSA Student ID: 404 -78 -3334 James E Page Phone: (317) 924 9367 3961 N Broadway College Level: Masters Indianapolis IN 46205 Advisor: SITYNE, O'NEAL Degree Program:URBAN MINISTRY STUDIES Previous Balance: $0.00 Description 8/23/2007 FA -07 Charged Tuition FA -07 $1,320.00 8/24/2007 FA -07 Computer Lab Usage $30.00 8/24/2007 FA -07 Student Activity $30.00 8/24/2007 FA -07 Safety and Public Service $100.00 12/14/2007 FA -07 Tuition Payment Charge I $1,480.00 Please Remit Payment To: Total 0.00 Martin University Attn: Bursar Office 2171 Avondale Place Indianapolis, IN 46218 Previous Balance: $0.00 Overall Balance: $0.00 DATE RECEIPT DESCRIPTION AMOUNT YOUR NEW YOUR OLD NUMBER RECEIVED BALANCE BALANCE RECEIVED OF MARTIN UNIVERSITY 36628 2171 AVONDALE PLACE INDIANAPOLIS, INDIANA 46218 (317) 543 -3248 V 1 SIGNATURE RECEIPT Y I 1 1 01/09 v i nz CLASSM, `D RI JApES E PAGE PTION i ?r RICE ..asAWIOUNT< w—., r...� aI r a Of pARTIN UNIVERSITY INC ca y wI I N D I A N A P O L I S I AI DATE AUTHORIZATION SUB -i O+ 00172338 9 tdQ7 ev7f& 10 TOTAL 4 1-1 REFERENCE NO. SERVER y l TAX V' ID-FOLIO/CHECK NOAIC. N0. STATE REG./DEPT: CLERK TIP SIGN H jI E RR� E TOT amw I, a ed to The Issuer Gre card kentlfle0 do em y Cie ad elawn es TOTAL lion. 3 2 0 S 8 0 Wa^ rft It Props pnsemelion. I promise to pay such TOTAL p tller d whh arty othercherpe� are thereon) wtlJect to and n eoowdence wtth Il,e apreemertt 9o�'e the use o• such card CUSTOMER RETAIN THIS COPY FOR YOUR RECORDS I I _ I 01/09 v JAaES E PAGE tdgTY, r CLA53 pESCRIPTtON Ate' "N OU PRICE k A a iiARTIN UNIVt:RSITY INC ao i INUTANAP0L IS IN JI r MIX 00172338 DATE AU NO IZATIO B J g REFEREN E TOTAL O y SERVER y ID -FOLIO /CHECK NOJLIC. NO. STATE TAX SIGN HERE R EG./DEPT. CLERK Tip X MISC. I The Iearror m a» card wa.mnea on dua Item b shown as TOTAL 401 q°P� pnsenaaon, t p m pa y the amamt O S32 w 0 5 1 •'a'a ■qw b and n a000,y,ree M, a+dr TOTAL overr V w�h any other cha due 1 wnwr.wyoy.rr u..a«,a `.�a CUSTOMER RETAIN TMS COPY FOR YOUR RECORDS i Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL An invoice or 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 James E Page Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Reimbursement Books $1,334.00 Total 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 Now%--WAR RANT NO. James E Page ALLOWED 20 IN SUM OF $1,334.00 ON ACCOUNT OF APPROPRIATION FOR GENERALFUND 1202 Informatin Systems Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I 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 20 15n re itl Cost distribution ledger classification if claim paid motor vehicle highway fund