HomeMy WebLinkAbout229722 2/25/2014 +.f CITY OF CARMEL, INDIANA VENDOR: 367964 Page 1 of 1
ONE CIVIC SQUARE XIAOHUA WU CHECK AMOUNT: $14.75
�? CARMEL, INDIANA 46032 14121 EQUINE CT
CARMEL IN 46074 CHECK NUMBER: 229722
CHECK DATE: 2/25/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 14 . 75 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1191061
Carmel 0 Cl:ay Payment Date: 01/09/14
Parks&Recreatlo� Household#: 51563
Monon Community Center FEB 1 1 2014 Xiaohua Wu Hm Ph:(317)818-1698
Carmel IN 46032 14121 Equine CT Wk Ph: (317)277-8764
BY: Carmel IN 46074 Cell Ph:(317)869-8089
xhwuO8@gmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
ROSTER CHANGE-Refund Of 14.75
Enrollee Name: Ethan Wu Fees+Tax Discount Prev Paid _ Cur Paid Amount Due
Activity Number: 343108-02 Learn to Swim Level 44.25 0.00 44.25 0.00 0.00
Enrollment Date: 12/02/2013 (Enrolled)
Class Location: Indoor Lap Pool 10 Class Dates: 01/05/2014 to 01/26/2014
Monon Community Cntr 6:OOP to 6:55P
Su
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 01109/14 @ 15:37:55 by KTOURNEY FEES ADJUSTED ON CHANGED ITEMS(=} 1475-
NET
475-NET AMOUNT:FROM CHANGED ITEMS 14:75
TOTAL AMOUNT REFUNDED 14.75
NEIN NET HOUSEHOLD BALANCE 0.00
Refund of=_> 14.75 Made By==>REFUND FINAN With Reference=_>
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
��----o Z i/ _
Authorized Signature Date Authorized Sigri6ture Date
/016,/v-`73f-6Yao
Escape Day Passes are non-refundable.
Page# 1 of 1
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.
Wu, Xiaohua Terms
14121 Equine Ct Date Due
Carmel, IN 46074
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
1/9/14 1191061 Refund $ 14.75
Total $ 14.75
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Wu, Xiaohua Allowed 20
14121 Equine Ct
Carmel, IN 46074
In Sum of$
$ 14.75
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-10 1191061 4358400 $ 14.75 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
20-Feb 2014
Signature
$ 14.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund