164430 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: T361914 Page 1 of 1
ONE CIVIC SQUARE ASIF SHARFUDDIN
CARMEL, INDIANA 46032 13816 FOUR SEASONS WAY CHECK AMOUNT: $562.18
WESTFIELD IN 46074 CHECK NUMBER: 164430
CHECK DATE: 9/3012008
D EPARTMENT ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
1047 4358400 562.18 REFUNDS AWARDS INDE
000182243
monon center Clerk: CMG
Date: 08/29/2008 Time: 20:39:14
H /H: Asif Sharfuddin
F /M: Asif Sharfuddin R TVEO
Description E Price F BY: 2 2008
Pass 0 Type 98.91
Prem. Yrly Ad R
From 05/26/2008 05/26/2009
F /M: Hala Fatima
Description Ext Price
Pass 0 Type 98.91
Prem. Yrly Ad R
From 05/26/2008 05/26/2009
Rcpt# 182243 Prev Bal: 0.00
New Charges 562.18
New Tax: 0.00
Total Due: 562.18-
Tot Refund: 562.18
New Bal: 0.00
Refund Type: Refund from Finance
REFUND FINAN •Refund of: 562.18
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.
Aut
Jio rized S7 gnature Date
Author zed Signature Date
Rcpt# 182243
o C�
J 26
Page
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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.
Sharfuddin, Asif Terms
13816 Four Seasons Way Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/29/08 182243 Refund 562.18
Total 562.18
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