2001, 06-13 Permit: 01004257 Refund\ �
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PROJECT#: 01004262
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Wednesday, June 13, 2001
Address 2516
PROJECT#: 01004257
2404 S REES LN
SPOKANE WA 99206
Phone: (509) 994-4691
(509) 994-4691
Use: RESIDENCE W/GARAGE - NATURAL GAS
RESIDENCE W/GARAGE - NATURAL GAS
Permit Issue Date: 6/11/2001
Application Date: 6/4/2001
Permit Issue Date: 6/11/2001
Application Date: 6/4/2001
6/11/2001 4:08:51 PM
Transaction Dat
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Overpayment — Reimbursed with PeopleSoft Voucher # 00091801 (pap).
Overpayment — Reimbursed with PeopleSoft Voucher # 00091801 (pap)
Vendor ID HAYDENTE01
Voucher ID 00091801
Rel Vchr ID
Dept ID
VENDOR:
Hayden Enterprises Inc
2622 SW Glacier Place Ste 110
Redmond OR 97756
Vendor Contact/Tel
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
BILL TO:
PAGE l OF 2
RC#
INV# 01-4257 & 4262
ENTERED DATE : 06/12/2001 PO DATE:
ENTERED BY: Patty Eickstadt
BUYER:
PURCHASING DIRECTOR: BELA G. KOVACS
LINE NO.
DESCRIPTION
ITEM ID
QUANTITY
UNIT
UNIT PRICE
EXTENDED AMOUNT
PO#
CHG ORD#
PO LINE#
PO SCHED#
CONTRACT#
1
2
100% - REFND'D OVERPYMNT W/CK
0
OVERPYMENT BY CK
0
0
0
1.0000
1.0000
EA
0
EA
0
0.00
0.00
35.00
35.00
LINE NO.
DISTRIB LINE
ACCOUNT
FUND
DEPTID
PROGRAM
CLASS
RPT CAT
BDPER
PC UNIT'
PAY THISAMOUNT
PROJECT
ACTIVITY
RES. TYPE
CATEGORY
SUB CAT
AM UNIT
PROFILE
ASSET FLG
ASSET ID
1
BACE
2
BACE
240
1
240
36981 406
REFND
36981 406 0300008
REFND
0300008
2001
2001
PROJA
PROJA
N
35.00
35.00
• Vendor ID HAYDENTE0I
Voucher ID 00091801
Rel Vchr ID
Dept ID
VENDOR:
Hayden Enterprises Inc
2622 SW Glacier Place Ste 110
Redmond OR 97756
Vendor Contact/Tel
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
BILL TO:
PAGE 2 OF 2
RC#
INV# 01-4257 & 4262
ENTERED DATE : 06/12/2001
PO DATE:
ENTERED BY: Patty Eickstadt
LINE NO.
DISTRIB LINE
ACCOUNT FUND DEPTID
PROGRAM
CLASS
BUYER:
PURCHASING DIRECTOR: BELA G. KOVACS
RPT CAT BDPER PC UNIT PAY THIS'' AMOUNT
PROJECT
ACTIVITY
RES. TYPE
CATEGORY
SUB CAT
AM UNIT PROFILE ASSET FLG ASSET ID
Comments: 100 % REFUNDED = PRJ # 01-4262 = SITE LOCATION OF: 2516 S REES LN.;
SPOKANE WA 99206 & PRJ# 01-4257 = SITE LOCATION: 2404 S
REES LN.; SPOKANE WA 99206.
DISCOUNT TOTAL: 0.00
FREIGHT TOTAL: 0.00
SALES TAX TOTAL: 0.00
SUBTOTAL: 70.00
USE TAX TOTAL: 0.00
GRAND TOTAL: 70.00
TOTAL TO VENDOR: 70.00
RECEIVING CERTIFICATION
Materials noted 111 quantity " have been received in good condition or
contracted for.
SIGNED
PAYMENT CERTIFICATION TRAVEL CERTIFICATION
1. the undersigned,do-hereby ceRirylrrderrlaity of perjury that sufficient funds have been budgeted I hereby certify under penalty of perjury that this
for this claim, e materials have been furnis' d, vices rendered or labor performed as described is a true and correct claim for necessary expenses
her of contr ted for, that the clat is a ju• ,due an. unpaid obligation against Spokane County incurred by me and that no payment has been received
nhenticate and certify to said claim. by me on account thereof.
or fund age tri cated above,
SIGNED
DATE 6/12/01 TITLE ACCT TECH 4 DATE 6/12/01
TITLE OFFICE ADMINISTRATOR
SIGNED
DATE TITLE