177653 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 363367 Page 1 of 1
ONE CIVIC SQUARE DON FISHER CHECK AMOUNT: $65.00
CARMEL, INDIANA 46032 5149 AVIAN WAY
�Ml�oh ta. CARMEL IN 46033 CHECK NUMBER: 177653
CHECK DATE: 9/29/2009
D EPART M ENT A CCOUN T PO NUMBER INVO NU MBER A MOUNT DESC RIPTION
.1047 4358400 335831 65.00 REFUNDS AWARDS INDE
GLOBAL REFUND RECEIPT IF a IN 9 v
1
Receipt 335831 SEP 7 2009 bP
Payment Date: 09/13/2009
Household 9101 LY.
Home Phone: (317)844 -9984
DON FISHER ��l(i r- i Monon Center
5149 AVIAN WAY Carmel IN 46032
CARMEL IN 4
P' W mi Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund retails
Oria Bal Refund New Bal
Module: Activity Registration 65.00- 65.00 0.00
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 65.00 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 CREDIT HOUSEHOLD BALANCE 65.00
Processed on 09/13/09 09:46:22 by MCC NEW REFUND AMOUNT 65.00
:TOTAL' •REFUNDABLE AMOUNTr.sa. 65iU0
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 65.00 Made By REFUND FINAN-" "With eference refundlb -day party
All refunds are subject to State Board of Accounts check will be
issued. No cash or cred 1;1 k "Jit
9 9
Authorized Signat re Date Authorized Signature Date
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.
Fisher, Don Terms
5149 Avian Way Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/13/09 335831 Refund 65.00
Total 65.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Fisher, Don Allowed 20
5149 Avian Way
Carmel, IN 46033
In Sum of
65.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 335831 4358400 65.00 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
24 -Sep 2009
Signature
65.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund