174503 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: T361507 Page 1 of 1
1 ONE CIVIC SQUARE PAUL SMITH CHECK AMOUNT: $15.00
-CARMEL, INDIANA 46032 5341 CREEKBEND DRIVE
CARMEL IN 46033 CHECK NUMBER: 174503
CHECK DATE: 7/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO DESCRIPTION
1047 4358400 15.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 275541
Payment Date: 06/15/2009
Household 19445
Home Phone: (317)575 -8584 JUN t
Work Phone:
4 2009
PAUL SMITH Monon Center
5341 CREEKBEND DRIVE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 15.00- 15.00 0.00
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 15.00 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 15.00
Processed on 06/15109 08:04:54 by RDG NEW REFUND AMOUNT 15.00
TOTAL REFUNDABLE AMOUNT 15.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 15.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. check ill be
issued. No cash or credit card refunds.
Authori'z Signature Date Authorized Signature Date
9 Z I U
Page #I 1
ACCOUNTS PAYABLE VOUCHER
4
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.
Smith, Paul Terms
5341 Creekbend Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6115109 275541 Refund 15.00
Total Is 15.00
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.
Smith, Paul Allowed 20
5341 Creekbend Drive
Carmel, IN 46033
In Sum of
15.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 275541 4358400 15.00 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
2 -Jul 2009
Signature
15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund