179124 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 363549 Page 1 of 1
ONE CIVIC SQUARE KATIE BAKER CHECK AMOUNT: $103.35
CARMEL, INDIANA 46032 12554 SANDSTONE RUN
�_�o CARMEL IN 46033 CHECK NUMBER: 179124
CHECK DATE: 11/11/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 346667 103.35 REFUNDS AWARDS INDE
000348667
0 @o0ry &000!0
Monon Center Clerk: SAB
Date: 10/26/2009 Time: 10:09:37
H /H: Katie Baker
F /M: Katie Baker
Description Ext Price
Pass 0 Ty e 144.65
Yly GF UnYimitd
From 04/17/2009 04/17/2010
Rcpt# 348667 Prev Bal: 0.00
New Charges 130.35
New Tax: 0.00
Total Due: 130.35
Tot Refund: 103.35
New Bal: 27.00
Refund Type: Refund from Finance
REFUND FINAN Refund of: 103.35
All refunds.are subject to state Board
of Accounts claim pr cedure T, may take
4 -6 weeks to proc s. A C ill be
issued rye -cash r c redi c refunds.
19 P� /Rq
c�
uthorized Signature Date
Authorized Signature Date
Fed Tax ID #35- 6000972
Rcpt# 348667 `l7� 7, Sg 00 OCT 3 0 7009
0@
BY........
Om
Page 1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
r
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.
Baker, Katie Terms
12554 Sandstone Run Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s))
Amount
D
103.35
10/26/09 348667 Refund
Total 103.35
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.
Baker, Katie Allowed 20
12554 Sandstone Run
Carmel, IN 46033
In Sum of
t. 103.35
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 348667 4358400 103.35 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
5 -Nov 2009
Signature
Accounts Payable Coordinator
Title