HomeMy WebLinkAbout231675 04/23/14 c1
';"' CITY OF CARMEL, INDIANA VENDOR: 368126
® ONE CIVIC SQUARE DAVID GIRDNER CHECK AMOUNT: S""'""52.00'
�.. CARMEL, INDIANA 46032 2171 POST ROAD CHECK NUMBER: 231675
9M,_pN Lo CLARKSVILLE TN 37042 CHECK DATE: 04/23/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 52.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt# 1235040
Carmel @lay Payment Date: 04/11/14
J
Darks&Recrcatlon Household #: 57948
Monon Community Center David Girdner Hm Ph: (931)801-6918
Carmel IN 46032 2171 Post Road Wk Ph: (317) -
Clarksville TN 37042 Cell Ph:(317) -
dcgirdner@gmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 52.00
Enrollee Name: David Girdner Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 347005-01 MCC Spring Open 2014 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/20/2014 (Cancelled)
Class Location: Gymnasium A Class Dates: 04/12/2014 to 04/12/2014
Monon Community Cntr 8:OOA to 8:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 04/11/14 @ 14:06:22 by MML FEES CHANGED ON CANCELLED ITEMS(+) 52.00-
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 52.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 52.00 Made By=_>REFUND FINAN With Reference=_>low enrollment
All refund subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued. l
Authorized Signature bate Autlo iz Signature Date
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.
Girdner, David Terms
2171 Post Road Date Due
Clarksville, TN 37042
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/11/14 1235040 Refund $ 52.00
i
Total $ 52.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Girdner, David Allowed 20
2171 Post Road
Clarksville, TN 37042
In Sum of$
$ 52.00
ON ACCOUNT OF APPROPRIATION FOR
109 - MCC
PO#orBoard Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
1096-50 1235040 4358400 $ 52.00 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
17-Apr 2014
Signature
$ 52.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund