HomeMy WebLinkAbout207789 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 366161 Page 1 of 1
ONE CIVIC SQUARE DELYNN HUFF CHECK AMOUNT: $76.00
CARMEL, INDIANA 46032 9768 KITTRELL DRIVE
INDIANAPOLIS IN 46280 CHECK NUMBER: 207789
CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 76.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 803073
Carmel O c loy Payment Date: 03/20/12
J Household ousehold 46300
Morton Community Center Delynn Huff Hm Ph: (317)706 -0482
Carmel IN 46032 MAR 2 6 2012 D 9768 Kittrell Drive Wk Ph: (317)338 -3113
Indianapolis IN 46280 Cell Ph: (317)716-6764
dhuff @vast- alert.com
Phone: (317)848 7275,
Fed Tax ID #35- 6000972
Pass Details
MEMBERSHIP CHANGE Refund Of 76.00
Pass Holder: Delynn Huff Fees +Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MCorp HH Mty (M CPHHM), #159500 0.00 0.00 0.00 0.00 0.00
Valid Dates: 03/09/2012 to 03/08/2013 (Pass Change)
Special Questions: Company: St. Vincent Health
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 03120/12 11:14:40 by MJN FEES ADJUSTED ON CHANGED ITEMS 76.00
NET AMOUNT FROM CHANGED ITEMS 7fi:00
n� PS In �c� ✓a�
TOTAL AMOUNT REFUNDED 76.00.
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 0` 76.00 7 Made By REFUND FINAN With Reference staff error
All refunds are subject to State Board of Accounts claim procedure and may tak weeolks to process. A check will be
issued. No cash or credit card refunds.
J 3/ 9 �l &122112
Aurl Signature Date Au or e Sign lure 5ate
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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.
Huff, Delynn Terms
9768 Kittrell Drive Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/20/12 803073 Refund 76.00
Total 76.00
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.
Huff, Delynn Allowed 20
9768 Kittrell Drive
Indianapolis, IN 46280
In Sum of
76.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #rDTLE AMOUNT Board Members
Dept
1092 803073 4358400 76.00 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
5 -Apr 2012
Signature
76.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund