212581 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 366523 Page 1 of 1
ONE CIVIC SQUARE JEANNE FITZGERALD
CARMEL, INDIANA 46032 6041 WINNPENNY LANE CHECK AMOUNT: $40.00
INDIANAPOLIS IN 46220 CHECK NUMBER: 212581
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 40 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 942650
Carmel * Clay Payment Date: 08/31/12
Parks&Recreation Household #: 45712
Monon Community Center Jeanne Fitzgerald Hm Ph: (317)254-9199
Carmel IN 46032 6041 Winnpeny Lane
Indianapolis IN 46220 Cell Ph:(317)965-9116
besmommy2000 @yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 40.00- 40.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 40.00
Processed on 08/31/12 @ 09:45:22 by BNT NEW REFUND AMOUNT(-) 40.00
TOTAL REFUNDABLE AMOUNT 40.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 40.00 Made By==>REFUND FINAN With Reference=_>advanced request
All refunds are subject to State Board of Accounts claim procedure and may -6 week process. A check will be
issued. No cash or cr dit card refunds.
Authorized Signature Date l A i ig ture /Dat
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.
Fitzgerald, Jeanne Terms
6041 Winnpeny Lane Date Due
Indianapolis, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8131/12 942650 Refund $ 40.00
Total $ 40.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Fitzgerald, Jeanne Allowed 20
6041 Winnpeny Lane
Indianapolis, IN 46220
In Sum of$
$ 40.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-70 942650 4358400 $ 40.00 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
6-Sep 2012
Signature
$ 40.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I