212783 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 366526 Page 1 of 1
ONE CIVIC SQUARE BRIAN STROUT CHECK AMOUNT: $95.00
CARMEL, INDIANA 46032 12847 DOUBLE EAGLE DRIVE
CARMEL IN 46033 CHECK NUMBER: 212783
CHECK DATE: 9/1212012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 95 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 939191
ar Me, 1 0 lay Payment Date: 08/23/12
.,Y Household#: 42726
Parrs&recreation
Monon Community Center Brian Strout Hm Ph: (317)706-1121
Carmel IN 46032 12847 Double Eagle Dr.
Carmel IN 46033 Cell Ph:(317)679-5306
Istrout @iuhealth.org
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 95.00- 95.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 95.00
Processed on 08/23/12 @ 13:05:15 by JDB NEW REFUND AMOUNT(-) 95.00
TOTAL REFUNDABLE AMOUNT 95.00-
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 95.00 Made By==>REFUND FINAN With Reference=_>staff error
All refunds are subject to State Board of Accounts claim procedure and may take 4-6 weeks to process. A check will be
issued. No cash or credit card refunds. ����, el— 8 23 /Z
Authorized Signature Date Auth ri d Si ure Date
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.
FAUC 242012
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Page# 1 of 1
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.
Strout, Brian Terms
12847 Double Eagle Dr. Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/23/12 939191 Refund $ 95.00
Total $ 95.00
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.
Strout, Brian Allowed 20
12847 Double Eagle Dr.
Carmel, IN 46033
In Sum of$
$ 95.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 939191 4358400 $ 95.00 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
$ 95.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund