HomeMy WebLinkAbout228073 1/14/2014 CITY OF CARMEL, INDIANA VENDOR. 367873 Page 1 of 1
ONE CIVIC SQUARE CYNTHIA MASSIF
CARMEL, INDIANA 46032 14524 SADDLEBACK DR CHECK AMOUNT: $30.00
CARMEL IN 46032
CHECK NUMBER: 228073
CHECK DATE: 1/14/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 30 . 00 REFUNDS AWARDS & INDE
POS REFUND RECEIPT
[FUR
Receipt# 1187226
Carmel 0 081Y DEC 3 0 2013 Payment Date: 12/27/13
Household #: 999999999
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Monon Community Center Internal Zzzhousehold
Carmel IN 46032
Cell Ph:
Phone: (317)848-7275
Fed Tax ID#35-6000972
POS Transaction Details
Misc: Table Tennis, TABLE Fees+Tax Discount Amount Due
Quantity: -6 30.00 0.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 12/27/13 @ 10:39:09 by KLB FEES CHANGED ON CANCELLED ITEMS(+) 30.00-
NET AMOUNT FROM CANCELLED ITEMS 30.00-
TOTAL AMOUNT REFUNDED 30.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 30 de By==>REFUND FINAN With Reference=_>
C
d wi ell b mailed to Cynthia Massie
ddleback Dr.
N 46032
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
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Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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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.
Massie, Cynthia Terms
14524 Saddleback Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/27/13 1187226 Refund $ 30.00
Total $ 30.00
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.
Massie, Cynthia Allowed 20
14524 Saddleback Dr
Carmel, IN 46032
In Sum of$
$ 30.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1096-50 1187226 4358400 $ 30.00 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
9-Jan 2014
Signature
$ 30.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund