213103 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 366553 Page 1 of 1
tl ONE CIVIC SQUARE TONYA MILLER
I CHECK AMOUNT: $820.00
CARMEL, INDIANA 46032 13154 PENNEAGLE DRIVE
CARMEL IN 46033 CHECK NUMBER: 213103
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 820 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 945885
Carmel lay Payment Date: 09/10/12
Pa. r ation Household #: 14959
Monon Community Center Tonya Miller Hm Ph: (317)844-6469
Carmel IN 46032 13154 Penneagle Dr
Carmel IN 46033 Cell Ph:
Phone: (317)848-7275 tonyalee1969 @gmail.com
Fed Tax ID#35-6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 820.00- 820.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 820.00
Processed on 09/10/12 @ 10:17:17 by BJJ NEW REFUND AMOUNT(-) 820.00
TOTALREF,UNDABLE.AMOUNT,;
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 820.00 Made By==>REFUND FINAN With Referent -_> 1082-3-4358400 �i IvW F ` !J
All refun s are subject to State Board of Accounts claim pr ay take 4-6 weeks to process. A check will be
issued o cash or credit card refunds.
Autho d 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.
L REC�I�fED
SEP 1 12012
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.
Miller, Tonya Terms
13154 Penneagle Dr Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/10/12 945885 Refund $ 820.00
Total $ 820.00
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.
Miller, Tonya Allowed 20
13154 Penneagle Dr
Carmel, IN 46033
In Sum of$
$ 820.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-3 945885 4358400 $ 820.00 1 hereby certify that the attached invoice(s), or
biil(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20-Sep 2012
4LLLfYZ"U11Zj
Signature
$ 820.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund