HomeMy WebLinkAbout205717 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 365963 Page 1 of 1
ONE CIVIC SQUARE AMY KOEHLER CHECK AMOUNT: $87.00
s' CARMEL, INDIANA 46032 12613 CARRINGTON PLACE
CARMEL IN 46033 CHECK NUMBER: 205717
CHECK DATE: 1/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 87.00 PARKS DEPARTMENT REFU
i
h
GLOBAL REFUND RECEIPT
Receipt 776929
Carm Cl ay Payment Date: 01/18/12
Household 45009
Parks&Recreatidn
Monon Community Center o RO L Amy Koehler Hm Ph: (269)290 -2011
Carmel IN 46032 �A� 0 Z012 12613 Carrington Place
Carmel IN 46033 Cell Ph:
amykoe369 @yahoo.com
Phone: (317)848-7275
Fed Tax ID #35- 6000972 'By.
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 80.00- 80.00 0.00
Module: Pass Management 7.00- 7.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 87.00
Processed on 01/18/12 09:01:57 by BJJ NEW REFUND AMOUNT
TOTAL REFUNDABLE AMOUNT 87.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 87.00 Made By REF U ND FINAN ilh Reference
All refu are subject to State oard of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue�J. o :::�hor credit c S.
A ed 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
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: //2011 cpry .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.
Koehler, Amy Terms
12613 Carrington Place Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1118/12 776929 Refund 87.00
Total 87.00
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.
Koehler, Amy Allowed 20
12613 Carrington Place
Carmel, IN 46033
In Sum of
87.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -99 776929 4358400 87.00 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
26 -Jan 2012
Signature
87.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund