168995 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: T362562 Page 1 of 1
f ONE CIVIC SQUARE JIM HEAVIN CHECK AMOUNT: $60.00
s�? CA_RMEL, INDIANA 46032 451 AMERICAN WAY N to
CARMEL IN 46032 CHECK NUMBER: 168995
CHECK DATE: 2/17/2009
DEPARTMENT ACCO PO NUMB INV OICE N UMBER AMOUNT DESCRIP
1047 4358400 225266 60.00 REFUNDS AWARDS INDE
FACILITY REFUND RECEIPT
Receipt 225266 %CFIVFi D
Payment Date: 02/05/2009
Household 4793 FEB 0 9 2009
Home Phone: (317)663 -3303
Work Phone:
BY:
JIM HEAVIN Monon Center
451 AMERICAN WAY N 1A Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Facility Reservation Details
CANCELLATION Refund Of 60.00
Facility: Monon Center, Meeting Room
Reserv. Contact: Jim Heavin, Cell: (317)696 -2290
Reserv. Number: 6588 Status: Cancelled
Purpose: Annual HOA Meeting
Anticipated Count: 30
Date Day Time Fees Tax Discount Prev Paid Cur Paid Amount Due
12/18/2008 Thu 6:OOP to 8:30P 90.00 0.00 0.00 90.00 0.00
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Program Room Non -R 90.00 1.00 0.00 0.00 90.00
Cancel Reason: Customer paid in full up front and only used the room for one hour.
Wants a $60 refund
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 60.00 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 02/05/09 11:34:09 by MCC FEES CHANGED ON CANCELLED ITEMS 150.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
CIL {7- 306_S D 0 SALES TAX CHARGED ON CANCELLED FEES 90.00-
7�p�, SURCHARGE APPLIED AGAINST CANCELLED FEES
��j NET AMOUNTFROM :CANCELLEDJTEMS
tuL 'TOTALQAMOUNT:REFUNDEO�,Er
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 60.00 Made By REFUND FINAN With Reference
Page 1
FACILITY REFUND RECEIPT
Receipt 225266
Payment Date: 02/05/2009
Household 4793
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.
The count for this line item will not be known until after the reservation date. Therefore, both the count and the extension are
left at zero for reservation purposes, but will be updated after the reservation date. As soon as this data is available, you will
be invoiced for the current amount due. Please remit to our office within 10 days of the invoice date.
Authorized Signature Date Authorized Signature Date
Purchase
Description
P.O.0 IK P or F
L/�- 3 00 SOCK 35� 00
BUCI et
Line escr
Purchaser
Approval D� -s _O
Page #2
ACCOUNTS PAYABLE VOUCHER
a
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.
Heavin, Jim WA� Terms
451 American Wera N 1A Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice( s) or bill(s)) Amount
2/5/09 225266 Refund 60.00
Total 60.00
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
a
Voucher No. Warrant No.
Heavin, Jim Way Allowed 20
451 American 1AtaR N 1 A
Carmel, IN 46032
In Sum of
60.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 225266 4358400 60.00 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
13 -Feb 2009
Lr Q/7
Signature
60.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund