HomeMy WebLinkAbout235617 08/06/14 'G�q
�`•�! Mf. CITY OF CARMEL, INDIANA VENDOR: 368513
® i'• ONE CIVIC SQUARE ELIZABETH MAIN CHECK AMOUNT: 5""`""`•6.00'
CARMEL, INDIANA 46032 5742 N EWING ST CHECK NUMBER: 235617
INDIANAPOLIS IN 46220 CHECK DATE: 08/06/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1315089 6.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1315089
Carmel *
'Ca' ou Household#Date: 8 9714
y H
Parks&Re+creatlon :7H
Monon Community Center Elizabeth Main Hm Ph: (317)658-4895
Carmel IN 46032 H_ 5742 N. Ewing St Wk Ph: (317)658-4895
Indianapolis In 46220 Cell Ph:(317)658-4895
main.liz@gmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 6.00
Enrollee Name: Jason Hsu Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 148004-19 Adaptive Flowrider 0.00 0.00 0.00 0.00 .0.00
Enrollment Date: 06/23/2014 (Cancelled)
Class Location: Flowrider Class Dates: 07/28/2014 to 07/28/2014
MC Outdoor Aquatics 7:OOP to 8:30P
M
Carmel, IN 46032 Scheduled Sessions: 1
Cancel Reason: Scheduling conflict
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/23/14 @ 15:56:08 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 6.00-
NET AMOUNT FROM CANCELLED ITEMS "':` 6.00r.
-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.
V/
Authorized Signature Date Autho ized Signature Date
Escape Day Passes are non-refundable.
C) qG70 -43) 400
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.
Main, Elizabeth Terms
5742 N. Ewing St Date Due
Indianapolis, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/23/14 1315089 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
Voucher No. Warrant No. `
Main, Elizabeth Allowed 20
5742 N. Ewing St
Indianapolis, IN_46220 i
i
In Sum of$
$ 6.00
ON ACCOUNT OF APPROPRIATION FOR
109-MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
,a
1096-70 1315089 4358400 $ 6.00 I;hereby certify that the attached invoice(s), or
bills)is(are)true.and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
"
E
4-Aug 2014
Signature
$ 6.00 Accounts Payable-Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i