216057 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 366812 Page 1 of 1
ONE CIVIC SQUARE CARA GRUMME
CARMEL, INDIANA 46032 13913 ROYAL SADDLE DRIVE CHECK AMOUNT: $286.00
?' CARMEL IN 46032 CHECK NUMBER: 216057
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 286 . 00 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt# 984827
Carmel I& lay Payment Date: 12/20/12
J Household #: 24043
Darks&Reereatlon
Monon Community Center I Cara Grumme Hm Ph: (317)223-9881
Carmel IN 46032 DEC 20 2012 13913 Royal Saddle Dr. Wk Ph: (317)580-9434
Carmel IN 46032 Cell Ph:(317)223-9881
Phone: (317)848-7275
cara@cfsrentals.com
�. _:-_____.__.__�._._ ...
Fed Tax ID#35-6000972
Pass Details
The following item reflects a payment towards a previous receipt
Pass Holder: Grant Grumme Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Sep Month PM (ESEMSP), #188314 211.00 0.00 0.00 153.00 58.00
Valid Dates: 09/04/2012 to 09/28/2012 (Pass Change)
The following item reflects a payment towards a previous receipt
Pass Holder: Grant Grumme Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Aug Month PM (ESEMAP), #190836 144.00 0.00 11.00 133.00 0.00
Valid Dates: 08/15/2012 to 08/31/2012 (Pass Change)
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 286.00
Processed on 12/20/12 Q 11:47:57 by JAB FEES ADJUSTED ON CHANGED ITEMS(+) 0.00
I NET AMOUNT FROM CHANGED ITEMS 0.00
HH BALANCE APPLIED TO THIS RECEIPT(+) 286.00-
TOTAL AMOUNT REFUNDED 286.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 286.00 Made By=_>REFUND FINAN With Reference==>check refund
Payment of=_> 286.00 Made By=_> Pass Management Credit Balance
All refunds are subject to State Boar f Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
is d.
Autho ized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
kffw-o Vu
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.
Grumme, Cara Terms
13913 Royal Saddle Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/20/12 984827 Refund $ 286.00
i
Total $ 286.00
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.
Grumme, Cara Allowed 20
13913 Royal Saddle Dr
Carmel, IN 46032
In Sum of$
$ 286.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-3 984827 4358400 $ 286.00 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
3-Jan 2013
Signature
$ 286.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund