HomeMy WebLinkAbout212622 09/12/2012 a CITY OF CARMEL, INDIANA VENDOR: 366525 Page 1 of 1
ONE CIVIC SQUARE HEATHER HOLLAND CHECK AMOUNT: $189.11
�o CARMEL, INDIANA 46032 8522 FAWN MEADOW DR
a«o� INDIANAPOLIS IN 46256 CHECK NUMBER: 212622
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 189 . 11 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 941098
err Payment Date: 08/27/12
i��.'t 'c�A Household #: 29152
- rids r� etreate On
Monon Community Center Heather Holland Hm Ph: (317)697-9904
Carmel IN 46032 AUG 2 9 2012 8522 Fawn Meadow Dr
Indianapolis IN 46256 Cell Ph:
��__ heather8331 @yahoo.com
Phone: (317)848-7275 —=_
Fed Tax ID #35-6000972
Refund Details
Orio Bal Refund New Bal
Module: Pass Management 189.11- 189.11 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 189.11
Processed on 08/27/12 @ 12:00:18 by TLP NEW REFUND AMOUNT(-) 189.11
TOTAL REFUNDABLE AMOUNT 189.11
L 0 9 Z4 U NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 189.11 Made By==>REFUND FINAN With Reference-_>upgrading to MCAM&UG
All refunds are subject to State Board of Accounts claim procedure and may to -6 weeks to process. A check will be
issued. No cash or credit card refunds.
Authorized Signature Date uthori ed ignat a ate
Join us for Tour de Carmel
Bike along with us on Saturday, September 15, as we highlight some of the best parks, businesses, and entertainment Carmel
has to offer. This is a safe and family friendly event that allows you to create lasting memories while promoting fitness. From
training wheels to pedal clips, we have a route for you! Don't want to ride? Come volunteer with us! For more information visit
www.carmelclayparks.com.
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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.
Holland, Heather Terms
8522 Fawn Meadow Dr Date Due
Indianapolis, IN 46256
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) Amount
8/27/12 941098 Refund $ 189.11
Total Is 189.11
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.
Holland, Heather Allowed 20
8522 Fawn Meadow Dr
Indianapolis, IN 46256
In Sum of$
$ 189.11
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#(TITLE AMOUNT Board Members
Dept#
1092 941098 4358400 $ 189.11 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
6-Sep 2012
v
Signature
$ 189.11 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i
I