223687 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 367507 Page 1 of 1
ONE CIVIC SQUARE LAYANA WATTS
CARMEL, INDIANA 46032 9479 HADWAY DR CHECK AMOUNT: $5.00
?� INDIANAPOLIS IN 46256
CHECK NUMBER: 223687
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 5 . 00 REFUNDS AWARDS & INDE
001138126
@-ry&91 r-!❑
Monon Community Center Clerk: KLB
Date: 08/21/2013 Time: 15:08:02
Daily sale
Description Ext Price R E(7r, T VIED
----------------------------
Time In/Amt: 3:07P 5.00- AUG 2 2 201
Visit Type: MCC Grp Youth
Visit Date ==> 08/21/2013 BY:
visit Count: 1.00-
Rcpt# 1138126 Total Due: 5.00-
Tot Refund: 5.00
Refund Type: Refund from Finance
REFUND FINAN Refund of: 5 .00
Ref: over-charged
'r This refund will be mailed to:
Layana watts 1
9479 Hadway Dr. /
Indianapolis IN 46256
?Authori----- -- --- ------ ------------
gn ure Date
ed gnature Date
funds a e subject to state Board
Of Accounts procedures and may take 4-6
weeks to process. No cash refunds
will be issued.
Escape Day Passes are non-refundable.
Fed Tax ID #35-6000972
!
Rcpt# 1138126
-m
Page 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.
Watts, Layana Terms
9479 Hadway Dr Date Due
Indianapolis, IN 46256
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/21/13 1138126 Refund $ 5.00
Total $ 5.00
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.
Watts, Layana Allowed 20
9479 Hadway Dr
Indianapolis, IN 46256
In Sum of$
$ 5.00 _
ON ACCOUNT OF APPROPRIATION FOR
109 - MCC
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1092 1138126 4358400 $ 5.00 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
23-Aug 2013
Signature
$ 5.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund