HomeMy WebLinkAbout234509 07/08/14 �Coq
�'y.. '• CITY OF CARMEL, INDIANA VENDOR: 367750
® it ONE CIVIC SQUARE KAREN DEBOER CHECK AMOUNT: $********21.00*
�.oN ma y?: CARMEL, INDIANA 46032 1030 CHURCHILL COURT CHECK CHECK NUMBER: 07 08/14
'M,-��._.� INDIANAPOLIS IN 46280DATE:
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1294158 21.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1294158
ar' l IIIIIII, Clad Payment Date: 07/02/14
Household#: 289
Parks&Recreation
JUL - 3 2014
Monon Community Center BY: Karen DeBoer Hm Ph: (317)575-1993
Carmel IN 46032 _____.-__ _ 1030 Churchill Court Wk Ph: (317)337-3011
- Indianapolis IN 46280 Cell Ph:(317)525-4856
gkdeboer@yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 6.00
Enrollee Name: Caleb Deboer Fees+Tax Discount Prey Paid Cur Paid Amount Due
Activity Number: 148004-04 Adaptive Flowrider 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/07/2014 (Cancelled)
Class Location: Flowrider Class Dates: 06/24/2014 to 06/24/2014
MC Outdoor Aquatics 7:OOP to 8:30P
Tu
Carmel, IN 46032 Scheduled Sessions: 1
Cancel Reason: Scheduling Conflict
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 15.00
Processed on 07/02/14 @ 16:17:35 by MYADON FEES CHANGED ON-CANCELLED ITEMS(+) 6.00-
NET AMOUNT FROM CANCELLED ITEMS
HH BALANCE APPLIED TO THIS RECEIPT(+) 15.00-
TOTAL AMOUNT REFUNDED 21.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 21.00 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.
Z
Authorized Signature LDate Authorized Signature Dat
Escape Day Passes are non-refundable.
Ci q 6 7 0
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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.
DeBoer, Karen Terms
1030 Chruchill Court Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/2/14 1294158 Refund $ 21.00
Total $ 21.00
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
,20
Clerk-Treasurer
Voucher No. Warrant No.
DeBoer, Karen �I Ilowed 20
1030 Chruchill Court
Indianapolis, IN 46280
Ih Sum of$
$ 21.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
I
PO#or
Dept# INVOICE NO. ACCT#/TlTLE AMOUNT I Board Members
1096-70 1294158 4358400 $ 21.00 11hereby certify that the attached invoice(s), or
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
i
Which charge is made were ordered and
received except
i•
1.
I
I' 3-Jul 2014
I Signature
$ 21.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund