HomeMy WebLinkAbout213310 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 366576 Page 1 of 1
ONE CIVIC SQUARE RACHELLE RODRIGUEZ
CARMEL, INDIANA 46032 1005 W ANGELENO#A CHECK AMOUNT: $49.00
BURBANK CA 91506 CHECK NUMBER: 213310
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 49 . 00 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
a rm e! � lay Receipt# 955423
Payment Date: 10/03/12
Parks&Recreation Household #: 48751
Monon Camel IN 46032ty Center 0 w A �t� J ( 866 E 12goh�ue� Hm Ph: (317)460-1408
J CarD l--N-46033 Cell Ph:
Phone: (317)848-7275 �) (/V1 -/rd'-driguez20 @yahoo.com
Fed Tax ID#35-6000972 u
Refund Details `. ». ' D
OCT U 3 2012 Oria Bal Refund New Bal
Module: Pass Management 49.00- 49.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 49.00
Processed on 10/03/12 @ 09:43:07 by JAB NEW REFUND AMOUNT(-) 49.00
� 4 " I TOTAL REFUNDABLE AMOUNT 49.00
ftt/V ,/ L NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 49.00 Made By==>REFUND FINAN With Reference=_>check refund
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.
to h / «
rthrzed Signature Date Authorized Signature Date
Join us at West Park on Saturday, October 6, from 4-9pm, for our Fall Food Festival & Benefit. Local food trucks, restaurants,
and beer/wine vendors compete to be the first ever Fall Food Festival Winner! Try their favorite dishes, relax with the music,
and enjoy a beautiful day at the park with your family. Help children and families participate in department-wide activities;
proceeds will help fund scholarships. $5/person entry fee. There will be an additional cost for food and drink purchases.
Register online at www.carmelclayparks.com.
Escape Day Passes are non-refundable.
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.
Rodriguez, Rachelle Terms
1005 W. Angeleno #A Date Due
Burbank, CA 91506
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/3/12 955423 Refund $ 49.00
Total $ 49.00
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.
Rodriguez, Rachelle Allowed 20
1005 W. Angeleno#A
Burbank, CA 91506
In Sum of$
$ 49.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept#
1081-7 955423 4358400 $ 49.00 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
4-Oct 2012
Signature
$ 49.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund