HomeMy WebLinkAbout235579 08/06/14 �)�� C4q';'? CITY OF CARMEL, INDIANA VENDOR: 367750
r ONE CIVIC SQUARE KAREN DEBOER CHECK AMOUNT: $*********6.00*
s, z, CARMEL, INDIANA 46032 1030 CHURCHILL COURT CHECK NUMBER: 235579
9�i��oN-�o• INDIANAPOLIS IN 46280 CHECK DATE: 08/06/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1318639 6.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1318639
Carmel 19 Clay Payment Date: 07/29/14
Parks&Recreafidh Household #: 289
Monon Community Center 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 Prev Paid Cur Paid Amount Due
Activity Number: 148004-09 Adaptive Flowrider 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/07/2014 (Cancelled)
Class Location:-- Flowrider Class Dates: 07/29/2014 to 07/29/2014
MC Outdoor Aquatics 7:OOP to 8:30P
Tu
Carmel, IN 46032 Scheduled Sessions: 1
Cancel Reason: We had to cancel because of weather
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/29/14 @ 19:34:57 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 6.00-
NET AMOUNT FROM CANCELLED ITEMS 6.00-
TOTAL 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.
UAM4VI '17 G
4" AAuthorized Signature Date Snature
Date
Escape Day Passes are non-refundable.
77-�E
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 Churchill Court Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/29/14 1318639 Refund $ 6.00
Total $ 6.00
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
20Clerk-Treasurer
Voucher No. Warrant No.
DeBoer, Karen Allowed 20
1030 Churchill Court
'Indianapolis, IN 46280
In Sum of$
$ 6.00
ON ACCOUNT OF APPROPRIATION FOR
i
109 -MCC
PO#or Board Members
Dept# INVOICE No. ACCT#/TITLE AMOUNT
1096-70 1318639 4358400 $ 6.00 1 hereby certify that the attached invoice(s), or
bI lls)is(are)true and correct and that the
materials or services itemized thereon for
Which charge is made were ordered and
received except
I
.i
i
I
f 4-Aug 2014
Signature
$ 6.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
r
claim paid motor vehicle highway fund
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