HomeMy WebLinkAbout226662 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 367773 Page 1 of 1
' ONE CIVIC SQUARE TODD FOLAND
CARMEL, INDIANA 46032 11780 GATWICK VIEW DRIVE CHECK AMOUNT: $35.00
WI
+� FISHERS IN 46038
«o„ CHECK NUMBER: 226662
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4398400 1174784 39 . 00 REFUNDS AWARDS & INDE
PASS REFUND RECEIPT
Receipt# 1174784
Payment Date: 11/20/13
Household #: 35031
forks&- eGl7cati an
Monon Community Center Todd Foland Hm Ph: (317)517-6239
Carmel IN 46032 11780 Gatwick View Dr. Wk Ph: (317)616-5787
Fishers IN 46038 Cell Ph:
todd.foland @monster.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
MEMBERSHIP CHANGE-Refund Of 35.00
Pass Holder: Todd Foland Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly (M MCAM), #216782 70.00 0.00 70.00 0.00 0.00
Valid Dates: 08/27/2013 to 08/27/2014 (Pass Cancellation) _
Pass Comments:
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 11/20/13 @ 14:34:39 by MNS FEES ADJUSTED ON CHANGED ITEMS(+) 35.00-
NE7�AMOUNT;FROM CHANGED ITEMS 35.00-`'
4,T,OTAL''AMOUNT,REFUNDED 35.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 35.00 Made By=_>REFUND FINAN With Reference=_>Cancellation Refund
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
NOV 21 2013 I
Y: 1
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.
Foland, Todd Terms
11780 Gatwick View Dr. Date Due
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
118/20 1174784 Refund $ 35.00
Total $ 35.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Foland, Todd iallowed 20
11780 Gatwick View Dr.
Fishers, IN 46038
In Sum of$
$ 35.00
ON ACCOUNT OF APPROPRIATION FOR
109 - MCC
PO#or INVOICE NO, ACCT#/TITLE AMOUNT Board Members
Dept#
1092 1174784 4358400 $ 35.00 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
27-Nov 2013
yljmkm'z��
Signature
$ 35.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund