160579 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: T361386 Page 1 of 1
sq,4 ONE CIVIC SQUARE ADAM SILVERMAN CHECK AMOUNT: $80.00
o CARMEL, INDIANA 46032 13988 WILDCAT DR
CARMEL IN 46033 CHECK NUMBER: 160579
tr a
CHECK DATE: 6/1012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4358400 125288 80.00 REFUNDS AWARDS INDE
qvl
ACTIVITY REFUND RECEIPT
Receipt 125288
Payment Date: 06/06/2008
Household 5497
Home Phone: (317)844 -3925
Work Phone: (877)844 -3925
ADAM SILVERMAN Monon Center
13988 WILDCAT DR Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Sal Refund New Bat
Module: Activity Registration 80.00- 80.00 0.00
G1L Code De_scrilptio Accou Numb er_ Cst Cntr Description Account Numbe Amo unt
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 80.00 DR
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 80.00
Processed on 06/06/08 10:48:20 by JAS NEW REFUND AMOUNT 80.00
TOTAL REFUNDABLE AMOUNT 80.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 80.00 Made By JOURNAL -RF With Reference 5052- refund
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue No cash or credit card refunds. (J
th r' ed 'nature Date Authorized Signature Date
l�
JUUV 9 2008
BY:
Page 1
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.
Silverman, Adam Terms
13988 Wuildcat Dr Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
616108 125288 Refund 80.00
Total 80.00
I 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.
J
Silverman, Adam Allowed 20
13988 Wuildcat Dr
Carmel, IN 46033
In Sum of
80.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1046 125288 4358400 80.00 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 -Jun 2008
Signature
80.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund