171923 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 362804 Page 1 of 1
ONE CIVIC SQUARE ANDREA LIEBROSS
CARMEL, INDIANA 46032 12519 GLENDURGAN DR CHECK AMOUNT: $87.00
CARMEL 1N 46032
CHECK NUMBER: 171923
CHECK DATE: 4/2912009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 245064 67.00 REFUNDS AWARDS 1NDE
1-1 ACTIVITY REFUND RECEIPT
Receipt 245064 Z 0 a
Payment Date: 04/03/2009
Household 3842 APR 16 2009
Home Phone: (317)705 -1602
Work Phone:
BY:
ANDREA LIEBROSS Monon Center
12519 GLENDURGAN DR. Carmel IN 46032
CARMEL IN 46032
1,
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bat
Module: Activity Registration 67.00- 67.00 0.00
G1L Code Desc Accou Number Cs Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 67.00 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 HOUSEHOLD BALANCE 67.00
Processed on 04103/09 16:59:47 by LVA NEW REFUND AMOUNT 67.00
TOTAL REFUNDABLE AMOUNT 67.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 67.00 Made By REFUND FINAN With Reference low enrollment Photo
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.
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Authorized S' alure D to Authorized Signature Date
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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.
Liebross, Andrea Terms
12519 Glendurgan Dr Date Due
Carmel, IN 46032
l
t
i
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/3/09 245064 Refund 67.00
Total I 67.00
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.
Liebross, Andrea Allowed 20
12519 Glendurgan Dr
Carmel, IN 46032
In Sum of
67.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO #or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1047 245064 4358400 67.00 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
22 -Apr 2009
Signature
67.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i