HomeMy WebLinkAbout202705 10/11/2011 CITY OF CARMEL, INDIANA VENDOR: 365706 Page 1 of 1
ONE CIVIC SQUARE BILL PALMER CHECK AMOUNT: $70.00
CARMEL, INDIANA 46032 3732 DOTY LANE
CARMEL IN 46033 CHECK NUMBER: 202705
CHECK DATE: 10/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 70.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 733787
Payment Date: 09/28/11
Household 7057
Monon Community Center Palmer Bill Hm Ph: (317)843 -1733
Carmel IN 46032 3732 Doty Lane Wk Ph: (317)843 -1958
Carmel IN 46033 Cell Ph: (317)750 -1733
nanpalm4798 @aol.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 70.00
Pass Holder: Laura Palmer Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly (M MCAM), #136919 105.00 0.00 0.00 105.00 0.00
Valid Dates: 05/12/2011 to 05/12/2012 Pass Cancellation)
Cancel Reason: went back to school TDJ 9/28/11
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/28/11 13:56:09 by TDJ FEES CHANGED ON CANCELLED ITEMS 175.00
II SURCHARGE APPLIED AGAINST CANCELLED FEES 105.00
SIdhT qt L C- 4ixe,(le l f9A NET AMOUNT FROM CANCELLED ITEMS,:. 70.00
G L 09 a 143 5 1 TOTAL AMOUNT REFUNDED 70.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 70.00 Made By REFUND FINAN With Reference cancel error TDJ
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.
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Aut on ed Si lure Date u orize Signature Date
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Volunteers are the foundation of Carmel Clay Parks Recreation and we need your help! We are currently seeking volunteers
for special events, adaptive programs, parks and greenways, and Extended School Enrichment. 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.
Palmer, Bill Terms
3732 Doty Lane Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/28/11 733787 Refund 70.00
Total 70.00
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
Voucher No. Warrant No.
Palmer, Bill Allowed 20
3732 Doty Lane
Carmel, IN 46033
In Sum of
70.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 733787 4358400 70.00 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
6 -Oct 2011
Signature
70.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I