223179 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 367439 Page 1 of 1
ONE CIVIC SQUARE SUSAN RIVERS
CARMEL, INDIANA 46032 19555 LANDRUM CIRCLE CHECK AMOUNT: $94.50
NOBLESVILLE IN 46062
CHECK NUMBER: 223179
CHECK DATE: 8/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 94 . 50 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt# 1122829
Carmel I& Clay Payment Date: 08/05/13
Household #: 43981
DarksAecreativn -- __--
i -
Monon Community Center AUG 5 2013 Susan Rivers Hm Ph: (317)344-2218
Carmel IN 46032 19555 Landrum Circle Wk Ph: (317)415-6745
Noblesville IN 46062 Cell Ph:(941)730-5237
suerivers56@yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 94.50- 94.50 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 94.50
Processed on 08/05/13 @ 09:53:57 by BJJ NEW REFUND AMOUNT(-) 94.50
TOTAL REFUNDABLE AMOUNT 94:50
> NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 94.50 Made By =>REFUND FINAN W ti Reference=_> 1081-3-4358400 C �
All refunds re subject to Sta Board of Account procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Aut ignature Date Authorized Signature Date
Escape Day Passes are non-refundable.
I
0
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.
Terms
Rivers, Susan
Date Due
19555 Landrum Circle
Noblesville, IN 46062
Invoice Invoice Description
Amount
Date Number (or note attached invoice(s) or bill(s))
$ 94.50
8/5/13 1122829 Refund
Total $ 94.50
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.
Rivers, Susan Allowed 20
19555 Landrum Circle
Noblesville, IN 46062
In Sum of$
$ 94.50
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITLE AMOUNT
1081-3 1122829 4358400 $ 94.50 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
8-Aug 2013
Signature
$ 94.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund