HomeMy WebLinkAbout226865 12/03/2013 �,��f CITY OF CARMEL, INDIANA VENDOR: 360074 Page 1 of 1
ONE CIVIC SQUARE SUE WOLFGANG CHECK AMOUNT: $36.02
.o CARMEL, INDIANA 46032 C/O HUMAN RESOURCES
,o�.�a ONE CIVIC SO CHECK NUMBER: 226865
CARMEL IN 46032
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4350900 36 . 02 OTHER CONT SERVICES
Indiana Payment Portal Page 1 of 1
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Your transaction is complete
Your transaction is complete. Print this receipt for your records. Your receipt identification number
is 9703363. Please reference this number in any correspondence regarding your transaction.
.. .. ... .......... .... ....
Payer Information ?
SUSAN WOLFGANG
168 ASPEN WAY
CARMEL, IN 46032
Phone : 317 - 800 - 0697
Email : swolfgang @carmel.in.gov
Account Information ?
exp. 09/16
Transaction Details
Unit Extended
Description Price
Quantity Price
Instant Access Fee $1.12 1 $1.12
Commission Revision Fee $5.00 1 $5.00
:Total : $6.12;
The following amounts have been charged to your credit card. Your credit card statement will show
the following merchant name(s) and amount(s) for this transaction.
Merchant Amount
IN Sec of State 800-236-5446 $6.12;
The total amount charged to your credit card is $6.12.
Privacy Statement
D C u 0 2 2013
DEC
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https://secure.in.gov/apps/kwikekard/checkout/servlet/receipt?token=EC 1840229D2C32... 11/26/2013
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THAT UNI,THE, NAKE AND BY THE, LITHO-RITY OF
THE.STATE,OF INDIANA, I DO III AEBY APPOINT AND (:OM FISSION AS
Notary Public
COMMISSION NUMBER: 549694
SUSAN E. WOLFGANG
168 ASPEN WAY
CARMEL, IN 46032
WITHIN AND FOR THE COUNTY OF HAMILTON
AND THE STATE OF INDIANA
FROM JUNE 16, 2006 UNTIL AND EXPIRING ON JUNE 15, 2014
TA JJn s1 v-m Whereof
" I HAVE HEREUNTO SET MY HAND AND
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' , `'' ♦,"♦•♦ate CAUSED TO BE AFFIXED THE SEAL OF
',.++♦+{�` '� °+« ► THE STATE, AT THE CITY OF
INDIANAPOLIS, ON NOVEMBER 26, 2013
-- ' MITCH DANIELS - GOVERNOR
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Order Confirmation
Order#:00-13370947 DATE: 11/26/2013 11:37 AM
Customer#:00-225734
Thank yoz/f)1' yortr order. Please print this invoice for your records.
Ship To: Bill To:
Susan Wolfgang Susan Wolfgang
City of Carmel City of Carmel
1 Civic Square 168 Aspen Way
Carmel,IN 46032 Carmel,46032
Shipping Option:US Pos!rA Service We have assigned you a custorner ID#:00-225734
We have gilled the following card(s):
Visa 5529 $29.910
>>> CLICK HERE toActivatepourOnfine Menrhership
Order Summary:
Item# Item Name Qty. Price/Ea. Total
IN219 Indiana Notary Self-inking Stamp(Round) 1 $23.95 $23.95
Notary Name:SUSAN WOLFGANG
County Name:HAMILTON
Appointment#:549694
Expiration Date tmrrvddryyyyl:06/15/2014
Round Stamp Case Color:Red
Round Stamp Ink Color:Black
Impression:#1
Special instructions: Subtotal: $23.95
_.. US Postal Service: $5.95
Discount: -$0.00
Sales Tax: $0.00
GRAND TOTAL: $29.90
RECEIVED: $29.90
BALANCE DUE: $0.00
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8811 Westheimer,Suite 207
Houston,Texas 77063
1-800-721-2663 Fax 1 800-721-2664
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https://secure.authorize.net/gateway/transact.dil 11/26/2013
VOUCHER NO. WARRANT NO.
ALLOWED 20
Wolfgang, Sue
IN SUM OF $
Employee
$36.02
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1201 9703363 43-509.00 $6.12 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
1201 00-13370947 43-509.00 $29.90
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, December 02, 2013
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
11/26/13 9703363 Reimburse Comm Revision Fee $6.12
11/26/13 00-13370947 Reimburse Notary Stamp $29.90
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