212806 09/12/2012 \�f CITY OF CARMEL, INDIANA VENDOR: 366527 Page 1 of 1
ONE CIVIC SQUARE SHERRY WARREN
CARMEL, INDIANA 46032 13844 SALSBURY CREEK CHECK AMOUNT: $53.00
r CARMEL IN 46032
CHECK NUMBER: 212806
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 53 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 941068
Carmel lay Payment Date: 08/27/12
i ecreation Household#: 15296
Monon Community Center Sherry Warren Hm Ph: (317)569-0466
Carmel IN 46032 AUG 2 9 �; 13844 Salsbury Creek Wk Ph: (317)337-1020
Carmel IN 46032 Cell Ph:(317)501-1020
sherry @wls-enterprises.com
Phone: (317)848-7275 ':
Fed Tax ID#35-6000972 =
Refund Details
Orio Bal Refund New Bal
Module: Pass Management 53.00- 5100 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 53.00
Processed on 08/27/12 @ 11:12:47 by BJJ NEW REFUND AMOUNT(-) 53.00
TOTAL REFUNDABLE AMOUNT 53.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 53.00 Made By==>REFUND FINAN With Reference=_> 1081-8-4358400 C
All refu4s are subject to State Board of Accounts claim procedure and may take 4-6 weeks t process. A check will be
issuedlIflo cash or credit card refunds.
Auth ed Signature Date Authorized Signature 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.
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.
Warren, Sherry Terms
13844 Salsbury Creek Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number ' (or note attached invoice(s) or bill(s)) Amount
8/27/12 941068 Refund $ 53.00
Total $ 53.00
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.
Warren, Sherry Allowed 20
13844 Salsbury Creek
Carmel, IN 46032
In Sum of$
$ 53.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-8 941068 4358400 $ 53.00 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
$ 53.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund