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Home My WebLink About213183 09/25/2012 F CITY OF CARMEL, INDIANA VENDOR: T357587 Page 1 of 1 ' ONE CIVIC SQUARE MARY JANE STEGEMOLLER CHECK AMOUNT: $366.00 a CARMEL, INDIANA 46032 763 MARANA DR yioh�; CARMEL IN 46032 CHECK NUMBER: 213183 CHECK DATE: 9/25/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4358400 366 . 00 REFUNDS AWARDS & INDE PASS REFUND RECEIPT Receipt# 946253 Carmel @ Clay Payment Date: 09/10/12 Darks&Recreation 1 1 2012 Household #: 15654 s - -- - SEP Monon Community Center I Mary Jane Stegemoller Hm Ph: (317)574-0954 Carmel IN 46032 763 Marana Dr Wk Ph: (317)574-5400 BY: Carmel IN 46032 Cell Ph: stegkentfore@sbcglobal.net Phone: (317)848-7275 Fed Tax ID#35-6000972 Pass Details Pass Holder: Jake Stegemoller Fees+Tax Discount Prev Paid Cur Paid Amount Due Pass Type: 1-3 Week 2 PM (ESE1302P), #181876 38.00 0.00 0.00 38.00 0.00 Valid Dates: 08/20/2012 to 08/24/2012 (Pass Transfer from Flat Year PM) PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 09/10/12 @ 14:31:16 by JAB FEES ADJUSTED ON CHANGED ITEMS(+) 366.00- NET AMOUNT FROM CHANGED ITEMS 366.00- 1 TOTAL AMOUNT REFUNDED 366.00 Y ` NEW NET HOUSEHOLD BALANCE 0.00 Refund of=_> 366.00 Made By=_>REFUND FINAN With Reference=_> Payment of=_> 38.00 Made By=_> Pass Management Credit Balance All refunds are subject to State Board of Accounts claim procedure and may take 4-6 weeks to process. A check will be ed. No cash or credit card refunds. (0 LZ Autho ed Signatur 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. vVM� S S 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. Stegemoller, Mary Jane Terms 763 Marana Dr Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/10/12 946253 Refund $ 366.00 Total $ 366.00 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. Stegemoller, Mary Jane Allowed 20 763 Marana Dr Carmel, IN 46032 In Sum of$ $ 366.00 ON ACCOUNT OF APPROPRIATION FOR 108 - ESE PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1081-1 946253 4358400 $ 366.00 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 20-Sep 2012 "ZP&jUUY4Waj Signature $ 366.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund