HomeMy WebLinkAbout216037 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 366811 Page 1 of 1
ONE CIVIC SQUARE PENNY FOSTER CHECK AMOUNT: $73.97
CARMEL, INDIANA 46032 531 MERRIMAC DRIVE
WESTFIELD IN 46074 CHECK NUMBER: 216037
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 73 . 97 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt# 984465
Carmel 0 CI?Y Payment Date: 12/18/12
Household#: 24824
Parks&Recreatio r
Monon Community Center Penny Foster Hm Ph: (317)848-3499
Carmel IN 46032 531 Merrimac Drive
Westfield IN 46074 Cell Ph:
psuefoster @aol.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION-Refund Of 73.97
Pass Holder: Penny Foster Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: UnGrpFit Annual (M UGFA),#58299 226.03 0.00 0.00 226.03 0.00
Valid Dates: 03/13/2012 to 03/13/2013 (Pass Cancellation)
Cancellation Effective: 12/18/2012 —
Cancel Reason: employee now
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 12/18/12 @ 14:48:36 by HPG FEES CHANGED ON CANCELLED ITEMS(+) 300.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 226.03-
s=:N�T;iAMOII NT_'�FROMrCi4htCELIEDFIT:•EMS�4'��=�;�;t=:';?-",'�397�:=
,.T0Ti4VAM0UNTSREFUNDED,"i'
NEW NET HOUSEHOL BALANCE 0.00
Refund of=_> 73.97 Made By=_>REFUND FINAN With Reference=_>employee now
All refunds are subject to State Board of Ac ounts procedures and may take 4-6 ks to process. No cash refunds will be
issued.
IL
i1
Authorized Si na re Date A o zed ig lure D to '
Escape Day Passes are non-refundable.
DEC 9 2012
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.
Foster, Penny Terms
531 Merrimac Drive Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/18/12 984465 Refund $ 73.97
Total $ 73.97
I 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.
Foster, Penny Allowed 20
531 Merrimac Drive
'Westfield, IN 46074
In Sum of$
$ 73.97
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 984465 4358400 $ 73.97 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
3-Jan 2013
a&w �
Signature
$ 73.97 Accounts Payable_Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund