HomeMy WebLinkAbout229260 2/11/2014 CITY OF CARMEL, INDIANA VENDOR: 367941 Page 1 of 1
ONE CIVIC SQUARE JENNIFER ZIVOIN
to CARMEL, INDIANA 46032 5169 OLDFIELD CT CHECK AMOUNT: $196.00
CARMEL IN 46032 CHECK NUMBER: 229260
CHECK DATE: 2/11/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 196 . 00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1199766
Carmel olay __ Payment Date: 01/21/14
.l Household #: 31817
Darks&Recreatsdn .F. . -
.IAN 112Q14
Monon Community Center Jennifer Zivoin Hm Ph: (317)566-0180
Carmel IN 46032 — 15169 Oldfield Ct
Carmel IN 46032 Cell Ph:
jennifer@jzartworks.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 98.00
Enrollee Name: Jennifer Zivoin Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 347016-01 Social Ballroom Danc 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/03/2013 (Cancelled)
Primary Instructor: Rob Jenkins
Class Location: Dance Studio Class Dates: 01/17/2014 to 03/07/2014
Monon Community Cntr 6:15P to 7:15P
F
Carmel, IN 46032 Scheduled Sessions: 8
(317)848-7275
Cancel Reason: low enrollment
CANCELLATION - Refund Of 98.00
Enrollee Name: Romeo Zivoin Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 347016-01 Social Ballroom Danc 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/03/2013 (Cancelled)
Primary Instructor: Rob Jenkins
Class Location: Dance Studio Class Dates: 01/17/2014 to 03/07/2014
Monon Community Cntr 6:15P to 7:15P
F
Carmel, IN 46032 Scheduled Sessions: 8
(317)848-7275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 01/21/14 @ 16:05:08 by MML FEES CHANGED ON CANCELLED ITEMS(+) 196.00-
NET AMOUNT FROM CANCELLED ITEMS 196.00-
TOTAL AMOUNT REFUNDED 196.00
NEW NET CREDIT HOUSEHOLD BALANCE 20.00
Refund of=_> 196.00 Made By==>REFUND FINAN With Reference==>low enrollment
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued
Im
3
5 5'((-.�7/`7 Page# 1 of 2
ACTIVITY REFUND RECEIPT
CarmelClayReceipt# 1199766
f S&REQCFe tion Payment Date: 01/21/2014
Household #: 31817
Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
Page# 2 of 2
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized e rate must
show', kind
of service,
of units, price performed,
dates service rendered, by
whom, rates per day, number of h r
Payee Purchase Order No.
Terms
Zivoin, Jennifer Date Due
5169 Oldfield Ct
Carmel, IN 46032
Invoice Invoice
Description Amount
Date Number (or note attached invoice(s) or bill(s)) 196.00
1/21/14 1199766 Refund
Total $ 196.00
ccordance
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in a
with IC 5-11-10-1.6
20
Clerk-Treasurer
Voucher No. Warrant No.
Zivoin, Jennifer Allowed 20
5169 Oldfield Ct
Carmel, IN 46032
In Sum of$
$ 196.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or Board Members
Deptept# INVOICE NO. ACCT#/TITLE AMOUNT
1096-50 1199766 4358400 $ 196.00 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
7-Feb 2014
Signature
$ 196.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I