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Home My WebLink About239819 12/03/14 (9, CITY OF CARMEL, INDIANA VENDOR: 368885 ONE CIVIC SQUARE RICHARD UPTON CHECKAMOUNT: $********84.00* CARMEL, INDIANA 46032 6051 OSAGE DRIVE CHECK NUMBER: 239819 CARMEL IN 46033 CHECK DATE: 12/03/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 1370451 84.00 REFUNDS AWARDS & INDE �" ACTIVITY REFUND RECEIPT Receipt# 1370451 ren, Payment Date: 11/21/2014 ,+ Household#: 62294 :rK cue fi'' NOV 25 2014 BY: RICHARD UPTON Monon Community Center 6051 OSAGE DR. Carmel IN 46032 CARMEL IN 46033 Phone: (317)848-7275 Fed Tax ID#35-6000972 Enrollment Details CANCELLATION -Refund Of 38.00 Enrollee Name: Tommy Upton Fees+Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 243108-17 Learn to Swim Level 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 11/08/2014 (Cancelled) Class Location: Indoor Lap Pool 2 Class Dates: 12/02/2014 to 12/16/2014 Monon Community Cntr 4:OOP to 4:55P Tu Carmel, IN 46032 Scheduled Sessions: 3 (317)848-7275 Cancel Reason: advanced notice CANCELLATION -Refund Of 46.00 Enrollee Name: Dulcle Upton Fees+Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 243103-28 Preschool Level 1 7.00 0.00 0.00 7.00 0.00 Enrollment Date: 11/08/2014 (Cancelled) Class Location: Ind Leisure 3 Class Dates: 12/01/2014 to 12/15/2014 Monon Community Cntr 1 O:OOA to 10:45A M Carmel, IN 46032 Scheduled Sessions:. 3 (317)848-7275 Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee nAquatics Programs 7.00 1.00 0.00 0.00 7.00 Cancel Reason: advanced notice Page# 1 of 2 ACTIVITY REFUND RECEIPT . C�'1 flay. + Receipt# 1370451 : rl + r tion Payment Date: 11/21/2014 Household M 62294 PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 11/21/14 @ 11:31:31 by LWEPRICH FEES CHANGED ON CANCELLED ITEMS(+) 91.00- DISCOUNT APPLIED AGAINST CANCELLED FEES(-) 0.00 SALES TAX CHARGED ON CANCELLED FEES(+) 0.00 SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 7.00- NET AMOUNT FROM CANCELLED ITEMS- 84.00-- TOTAL-AMOUNT REFUNDED- NEW EFUNDED NEW NET HOUSEHOLD BALANCE 0.00 Refund of=_> 84.00 Made By=_>REFUND FINAN With Reference=_>refund of finance All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be issued. o I 1 p� � W IIA/M/ D V l l 1 A1Lq Authorized Signature Date Authorized Signature Date C0g6 /o. g35.� g00 Escape Day Passes are non-refundable. Page# 2 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. Upton, Richard Terms 6051 Osage Dr Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/21t14 . 1370451 _ Refund $ 84.00 _ Total $ 84.00 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 i. Voucher No. Warrant No. Upton, Richard Allowed 20- 6051 Osage Dr Carmel, IN 46033 ) In Sum_of$ t $ 84.00 ON ACCOUNT OF APPROPRIATION FOR I 109 -MCC I 4 P��# INVOICE NO. ACCT#/TITL AMOUNT Board Members C . P 1096-10 1370451 4358400 $ 84.00 i, 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 I. 26-Nov 2014_ i Signature $ 84.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund