The URL can be used to link to this page

Home My WebLink About236837 9 /10/2014 4 �pM*• CITY OF CARMEL, INDIANA VENDOR: 368618 ONE CIVIC SQUARE JACQUIN GALLAGHER CHECK AMOUNT: $**......12.00* CARMEL, INDIANA 46032 17041 SILVER VISTA LANE CHECK NUMBER: 236837 WESTFIELD IN 46074 CHECK DATE: - 09/10/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 43SB400 1339974 12.00 REFUNDS AWARDS & INDE I �( ','t'�Eillf-Iii'=:`:: k ACTIVITY REFUND RECEIPT Receipt# 1339974 �� " : . Payment Date: P09/01/14 Carmel f Clay ti )�, arks&Recreatioh f ' Household#: 17901 SEP - 2 1.0114 l Monon Community Center 11Jacquin Gallagher Hm Ph: (317)873-6662 Carmel IN 46032 17041 Silver Vista Lane Westfield IN 46074 Cell Ph:(317)250-6118 jherran@ccs.kl2.in.us Phone: (317)848-7275 Fed Tax ID#35-6000972 Enrollment Details CANCELLATION - Refund Of 6.00 Enrollee Name: Nicholas Herran Pees+Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 148004-12 Adaptive Flowrider 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 04/15/2014 (Cancelled) Class Location: Flowrider Class Dates: 08/19/2014 to 08/19/2014 MC Outdoor Aquatics 5:30P to 7:OOP Tu Carmel, IN 46032 Scheduled Sessions: 1 Cancel Reason: We had to cancel because of weather. CANCELLATION - Refund Of 6.00 Enrollee Name: Nicholas Herran Fees+Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 148004-13 Adaptive Flowrider 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 08/19/2014 (Cancelled) Class Location: Flowrider Class Dates: 08/26/2014 to 08/26/2014 MC Outdoor Aquatics 5:30P to 7:OOP Tu Carmel, IN 46032 Scheduled Sessions: 1 Cancel Reason: We had to cancel because of weather. PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 09/01/14 @ 15:12:27 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 12.00- NET AMOUNT.FROM CANCELLED ITEMS 12;00- TOTAL.AMOUNT REFUNDED 12.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of=_> 12.00 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. ff)o 17 ql"Laa" Lwfx I q Authorized Signa ure /� Date Authorized Signature Date G' 10 q C, Page# 1 of 2 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. Gallagher, Jacquin Terms 17041 Silver Vista Lane Date Due Westfield, IN 46074 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/1/14 1339974 Refund $ 12.00 Total $ 12.00 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. Gallagher, Jacquin Allowed 20 17041 Silver Vista Lane Westfield, IN 46074 In Sum of$ $ 12.00 ON ACCOUNT OF APPROPRIATION FOR 109 -MCC PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1096-70 1339974 4358400 $ 12.00 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 4-Sep 2014 ,Pb"~ Signature $ 12.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund