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HomeMy WebLinkAbout201200 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 365650 Page 1 of 1 ONE CIVIC SQUARE HOWARD ETHERINGTON s,. r CARMEL, INDIANA 46032 123 SHERMAN DRIVE CHECK AMOUNT: $90.00 CARMEL IN 46032 CHECK NUMBER: 201200 CHECK DATE: 9/13/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 90.00 REFUND PASS REFUND RECEIPT Receipt 721072 Payment Date: 08/29/11 Household 23652 Monon Community Center Howard Etherington Hm Ph: (317)844 -1409 Carmel IN 46032 123 Sherman Dr. Carmel IN 46032 Cell Ph: (317)403 -5336 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details MEMBERSHIP CHANGE Refund Of 90.00 Pass Holder: Beth Etherington Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: PT1 5x30 min (M PT1530), 9106461 60.00 0.00 60.00 0.00 0.00 Valid bates: 03/31/2011 to 06/30/2012 Pass Change) Pass Visit Info: Number Of Visits: 3 PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 0812911�1 10:�5 by LWW y FEES ADJUSTED ON CHANGED ITEMS 90.00- NET,AM0UNT FROWCHANGED1TEMS 90.00 "T0TAL'AM0l1NT,'REFU NDED 90.00: �7 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 90.00 Made By REFUND FINAN With Reference Check refund 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 cash or credit card refunds. UAl'i aj&�J Authorized Signature Date Authorized Signature Date Join us for St. Vincent Tour de Carmel, a bike ride along 10 -mile and 20 -mile routes through the city of Carmel. Rest stops will have a variety of healthy snacks, drinks and entertainment. After the ride, the finish line will offer more entertainment and refreshments. The cost is $8 per rider ($10 for same dayday -of registration). Pre- register online at www.carmelclayparks.com or pick up a form at the Monon Community Center. All participants will receive a goodie bag and a T -shirt if registered on or before August 26. The Adaptive 10 -mile Ride is for individuals with special needs only. Individuals will ride as a group on the 10 -mile route. Staff will be staggered within the group throughout the ride. Group will meet at the Monon Community Center in the designated tent at the start line for check -in at 8:00 a.m. Group will begin the ride at 8:30 a.m. sharp. AEG 3 1 2011 4 Page i 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. Etherington, Howard Terms 123 Sherman Dr. Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8129111 721072 Refund 90.00 'Total 90.00 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. Etherington, Howard Allowed 20 123 Sherman Dr. Carmel, IN 46032 In Sum of 90.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members Dept 1096 -22 721072 4358400 90.00 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 9 -Sep 2011 Signature 90.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund I