HomeMy WebLinkAbout234433 07/01/2014 {ur..fr�.1b
a`! �• CITY OF CARMEL, INDIANA VENDOR: 364510
(� CHECK AMOUNT: $'"'"""""6.00"
., '1• ONE CIVIC SQUARE SANDY WORKMAN
:. �_�; CARMEL, INDIANA 46032 7841 TANAGER LANE CHECK NUMBER: 234433
9���TON�°� INDIANAPOLIS IN 46256 CHECK DATE: 07/01/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1286526 6.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1286526
armel o ? Payment Date: 06/23/14
�T
Parks&Recreatidn Household#: 36087
Monon Community Center Sandy Workman
Carmel IN 46032 7841 Tanager Lane
Indianapolis IN 46256 Cell Ph:(317)501-0846
Phone: (317)848-7275 rwork6608@aol.com
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 6.00
Enrollee Name: Zachary Workman Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 148004-03 Adaptive Flowrider 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/01/2014 (Cancelled)
Class Location: Flowrider Class Dates: 06/17/2014 to 06/17/2014
MC Outdoor Aquatics 7:OOP to 8:30P
Tu
Carmel, IN 46032 Scheduled Sessions: 1
Cancel Reason: Scheduling conflict
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/23/14 @ 15:36:32 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 6.00-
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 6.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 6.00 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.
VL
Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
q G70
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.
Workman, Sandy Terms
7841 Tanager Lane Date Due
Indianapolis, IN 46256
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/23/14 1286526 Refund $ 6.00
Total $ 6.00
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
I
Voucher No. Warrant No.
Workman, Sandy ;Allowed 20
7841 Tanager Lane
Indianapolis, IN 46256
)In Sum of$
I
$ 6.00
I
i
ON ACCOUNT OF APPROPRIATION FOR �.
109 -MCC �
PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept#
1096-70 1286526 4358400 $ 6.00 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
i
26-Jun 2014
Signature
is 6.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i'