HomeMy WebLinkAboutRefund Request.pdfInvoice Vendor Invoice Date Number Fund Dept Sub Dept Account 21112012 02012012 100 17 070 3400 Prspared By: BECKY WHEELERSBURG --To close out the P.O. check box: EI Project # Line Item
(If applicable) (64 Characters or Less) BUILDING REVENUE THIS IS A REFUND Invoice Brief Description Dollar (64 Characters or Less) Amount REFUND PERMIT FEE FOR BP# 1285 $136.01 . Total
S 136.01 By signing below, I certify that all Items and/or services have been received, inspected, and accepted; and that this amount is correct and proper for payment. Department Head
Approval: (Accounting Use Only) Date Stamp: DATE: February 17, 2012 Invoice Accuracy Verified By: Posted By: MARC GUBE
Memo TO: Becky Wheelersburg FROM: Vola Mercer CC: DATE: 211/2012 RE: BLCO-1-12-2329 APPROVAL BY ANDY SCHWALLER: REASON FOR REFUND: iJJ:O 'J. ~ J,. {plu RE: Paid $136.01 on BLCO-9-09-1285
(see attached documents), this permit was voided on 10/22109 but amount was never refunded back to customer. AMOUNT OF REFUND: $136.01 THE REFUND SHOULD BE MAILED TO: NAME: Marc Gube
MAILING ADDRESS: 232 Aspen Rd Rifle, Colorado 81650 T:ICode Enfon:ementlSlgn PennitsIREFUND-memo.docx VENDOR#: VJ ~ \Cb ACCOUNU: C)'J Q -3 4 0 D ACCOUNT NAME: ~\!. W !I\Q, '\4!1!p1!'\
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