209033 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 366250 Page 1 of 1
ONE CIVIC SQUARE ERIN AMOS
s CHECK AMOUNT: $87.00
CARMEL, INDIANA 46032 10745 BUNKER HILL DRIVE
CARMEL IN 46032 CHECK NUMBER: 209033
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 87.00 REFUNDS AWARDS INDE
GLOBAL REFUND RECEIPT
Receipt 827805
of m' e I l ?y Payment Date: 05/17/12
marks &Recreation Household 44073
Monon Community Center Erin Amos Hm Ph: (317)460 -5642
Carmel IN 46032 10745 Bunker Hill Drive
Carmel IN 46032 Cell Ph:
e
Phone: (317)848 -7275 rinamos79 yahoo.com
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 87.00- 87.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 87.00
Processed on 05/17/112 15:54:08 by JAB NEW REFUND AMOUNT 87.00
TOTAL REFUNDABLE AMOUNT 87.00
V NEW NET HOUSEHOLD BALANCE 0.00
Refund of 87.00 Made By REFUND FINAN With Reference check refund
I refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issu d. No cash or credit card refunds.
7with re Da e Authorized Signature Date
Volu luoundation of Carme l Clay Parks Recreation and we need your help! We are currently seeking volunteers
for special events, adaptive programs, parks and greenways, and Extended School Enrichment. If interested, please call Dana
at 317.843.3868 or register online at https:H2011cpry .theregistrationsystem.com /en /1033!
DAY PASSES ARE NON REFUNDABLE
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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.
Terms
Amos, Erin
10745 Bunker Hill Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
87.00
5/17/12 827805 Refund
Totald 87.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with lc 5- 11- 10 -1.6
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Amos, Erin Allowed 20
10745 Bunker Hill Drive
Carmel, IN 46032
In Sum of
87.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -09 827805 4358400 87.00 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
17 -May 2012
Signature
87.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund