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Home My WebLink About178176 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 361617 Page 1 of 1 ONE CIVIC SQUARE ANGELA HAGAMAN CHECK AMOUNT: $250.67 CARMEL, INDIANA 46032 563 PONDS POINTE DRIVE CARMEL IN 46032 CHECK NUMBER: 178176 CHECK DATE: 10/14/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 342199 250.67 REFUNDS AWARDS INDE Jc I PASS REFUND RECEIPT Receipt 342199 Payment Date: 10/05/2009 OCT 0 6 2009 Household 15836 Home Phone: (317)844 -6848 ANGELA HAGAMAN Monon Center 563 PONDS POINTE DRIVE Carmel IN 46032 CARMEL IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 154.51 Pass Holder: Angela Hagaman Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Yly FT Alt Res (YFTAR), #69159 85.49 0.00 85.49 0.00 0.00 Valid Dates: 05/28/2009 to 05/28/2010 Pass Cancellation) Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee Yearly Fitness Adult 85.49 1.00 0.00 0.00 85.49 Cancel Reason: Husband layed off. CANCELLATION Refund Of 96.16 Pass Holder: Abigayle Suding Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Yly AQ Yth Res (YAQYR) #69090 53.84 0.00 53.84 0.00 0.00 Valid Dates: 05/27/2009 to 05/27/2010 Pass Cancellation) Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee Yearly Aquatics Yout 53.84 1.00 0.00 0.00 53.84 Cancel Reason: Husband layed off. 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 250.67 DR The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund. 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 0.00 Processed on 10/05/09 09:25:17 by CRB FEES CHANGED ON CANCELLED ITEMS 250.67 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 1. a NETAlV f O.UNTxFFI OM! CANCELLIED- f liT .EMS 2%67 Ti OTAU:,fAM0UNVREF,UNDED; 250:67`. Page 1 �o i PASS REFUND RECEIPT Receipt 342199 Payment Date: 10/05/2009 Household 15836 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 250.67 Made By REFUND F NAN With Reference h All refunds ar t to tate ar f counts cl 'm procedure and may take 4 -6 weeks to process. A check will be issu o cash or. credi card of v I Q A onzed Signatur D to Authorized Signature Date Page 2 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. Hagaman, Angela Terms 563 Ponds Pointe Drive Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/5/09 342199 Refund 250.67 Total 250.67 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 1 20 Clerk- Treasurer Voucher No. Warrant No. Hagaman, Angela Allowed 20 563 Ponds Pointe Drive Carmel, IN 46032 In Sum of 250.67 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 342199 4358400 250.67 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 7 -Oct 2009 Signature 250.67 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund