HomeMy WebLinkAbout201475 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 365655 Page 1 of 1
0 ONE CIVIC SQUARE LYNNETTE WILLIAMS
CARMEL, INDIANA 46032 1183 CAVENDISH DRIVE CHECK AMOUNT: $205.74
CARMEL IN 46032
CHECK NUMBER: 201475
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1096 4358400 205.74 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 716609
Payment Date: 08/19/11
Household 11892
Monon Community Center Lynnette Williams Hm Ph: (317)810 -9497
Carmel IN 46032 1183 Cavendish Drive
Carmel IN 46032 J :Cell Ph: (480)720-7522
Phone: (317)848 -7275
Fed Tax ID #35- 6000972 AUG 30 2011
Pass Details
CANCELLATION Refund Of 205.74
Pass Holder: Lynnette Williams Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: UnGrpFit Annual (M UGFA), #135566 94.26 0.00 0.00 94.26 0.00
Valid Dates: 04/26/2011 to 04/26/2012 Pass Cancellation)
Cancel Reason: pregnant; ca ge t injured
C__
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/19/11 11:16:15 by TLP FEES CHANGED ON CANCELLED ITEMS 300.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 94.26
NET AMOUNT FROM CANCELLED ITEMS 205.74
TOTAL AMOUNT REFUNDED 205.74
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 205.74 Made By REFUND FINAN With Reference
All refunds are subject 0 State Bo Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or cue it card re in
82
Authorized Signa u. bate Autfhorid nature bate
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 ($10 for same- dayday -of registration). Pre register online at www.carmelclayparks.com
or pick up a form at the Monon Community Center. All participants will receive a goodie bag and a T -shirt if registered on or
before August 26.
The Adaptive 10 -mile Ride is for individuals with special needs only. Individuals will ride as a group on the 10 -mile route. Staff
will be staggered within the group throughout the ride. Group will meet at the Monon Community Center in the designated tent
at the start line for check -in at 8:00 a.m. Group will begin the ride at 8:30 a.m. sharp.
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Williams, Lynnette Terms
1183 Cavendish Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/19/11 716609 Refund 205.74
Total 205.74
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No,
Williams, Lynnette Allowed 20
1183 Cavendish Drive
Carmel, IN 46032
In Sum of$
,k 205.74
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -22 716609 4358400 205.74 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
205.74 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund