HomeMy WebLinkAbout202043 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: T356523 Page 1 of 1
ONE CIVIC SQUARE JENNIFER BAIRD CHECK AMOUNT: $104.00
CARMEL, INDIANA 46032 1436 GWNNMERE RUN
CARMEL IN 46032
CHECK NUMBER: 202043
CHECK DATE: 9/27/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 104.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 728163
Payment Date: 09/14/11
Household 5816
Monon Community Center Jennifer Baird
Carmel IN 46032 Hm Ph: (317)587 -0092
1436 Gwnnmere Run Wk Ph: (317)688 -2000
Carmel IN 46032 Ext.2099
Phone: (317)848 -7275 bairdienniferw @yahoo.com Cell Ph:
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 52.00
Pass Holder: Patrick Baird Fees Tax Discount
Pass Type: 10- Visit (ESE IOV), #112982 Prev Paid Cur Paid Amount Due
Valid Dates: 08/10/2010 to 05/26/2011 Pass Cancellation) 78.00 0.00 78.00 0.00 0.00
Pass Visit Info: N
Cancel Reason: no longer using ese
CELLATION Refund Of 52.00
Pass Holder. Greta Baird Fees Tax Discount
Pass Type: 10 Visit (ESE10V), #112984 Prev !'aid Cur Paid Amount Due
Valid Dates: 08/10/2010 to 05/26/2011 Pass Cancellation) 78.00 0.00 78.00 0.00 0.00
Pass Visa Info: Number of V' 4
Cancel Reason: no longer using ese
Processed on 09114111 15:15:44 by BJJ PREVIOUS NET HOUSEHOLD BALANCE 0.00
FEES CHANGED ON CANCELLED ITEMS
104.00
NET AMOUNT FROM CANCELLED ITEMS -x00
TOTAL AMOUNT REFUNDED. 104',)0
NEW NET HOUSEHOLD BALANCE
0.00
Refund of 104.00 Made By REFUND FINAN With Reference
All refund are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. cash or credit card refunds.
ulhori d Signature Date
Authorized Signature Date
Volunteer with Us!
Volunteers are the foundation of Carmel Clay Parks Recreation and we need your help! We are currently seeking volunteers
far: Tour de Carmel (September 10), Barktember (September 11), and our Adaptive Programs (ongoing throughout the year).
If interested, please call Dana at 317.843.3868 or register online at https: //201 lcprv. theregistrationsystem .com /en/1033!
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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.
Baird, Jennifer Terms
1436 Gwnnmere Run Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/14/11 728163 Refund 104.00
Total 104.00
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
20_
Clerk- Treasurer