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Home My WebLink About158118 04/01/2008 �F CITY OF CARMEL, INDIANA VENDOR: T361079 Page 1 of 1 ONE CIVIC SQUARE ROBERT SCHOTT t CARMEL, INDIANA 46032 1028 SARATOGA CIRCLE CHECK AMOUNT: $60.80 'ti� INDPLS IN 46280 CHECK NUMBER: 158118 CHECK DATE: 411/2008 DEPAR ACCOUNT PO NUMBER INVOI N UMBER AMOUNT DESCRIPTION 104;'' 4358400 96527 60.80 REFUNDS AWARDS INDE PASS REFUND RECEIPT Receipt 96527 RECEIVED Payment Date: 02/28/2008 Household 11577 MAR 2 0 2008 Home Phone: (317)587 -1269 Work Phone: By: .f DELTA FAUCET _.f/r Monon Center 55 EAST 111TH STREET Carmel IN 46032 INDIANAPOLIS, IN 46280 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 60.80 Pass Holder: Robert Schott Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Prem. Yrly Ad R (PRMYRADR), #13795 121.60 0.00 121.60 0.00 0.00 Valid Dates: 08/28/2007 to 08/28/2008 Pass Cancellation) Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee Prem. Yearly Adult R 121.60 1.00 0.00 0.00 121.60 Cancel Reason: Chlorine bothered skin G/L Code Description Account Number Cst Cntr Description Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 60.80 DR The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund. Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers. PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 02/28/08 11:01:31 by EDR FEES CHANGED ON CANCELLED ITEMS 182.40 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 SURCHARGE APPLIED AGAINST CANCELLED FEES 121.60 NET AMOUNT,FROM CANCELLED ITEMS 6080 TOTAL,AMOUNT REFUNDED %80 NEW NET HOUSEHOLD BALANCE 0.00 Refund Type: Refund from Finance Refund of 60.80 Made By JOURNAL -RF With Reference This refund will be mailed to Robert Schott 1028 Saratoga Circle Indianapolis, IN 46280 Page 1 PASS REFUND RECEIPT Receipt 96527 Payment Date: 02/28/08 Household 11577 All refunds are sub'e o State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issu o car cnE card refunds. I No,? Author d ignature Date Authorized Signature Date Page 2 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. Robert Schott Terms 1028 Saratoga Circle Date Due Indianapolis, IN 46280 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/28/08 96527 Refund 60.80 Total 60.80 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. Robert Schott Allowed 20 1028 Saratoga Circle Indianapolis, IN 46280 In Sum of 60.80 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 96527 4358400 60.80 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 24 -Mar 2008 Signat re 60.80 Business Services Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund