242333 02/17/15 o
CITY OF CARMEL, INDIANA VENDOR: 369113
ONE CIVIC SQUARE NICHOL KAPLAN CHECK AMOUNT: S********45.00*CARMEL, INDIANA 46032 13801 PALO ALTO CT CHECK NUMBER: 242333
CARMEL IN 46074 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1403667 45.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1403667
CarMeleClay = � - � t ..4-_� i
Payment Date: 02/09/15
Household #: 24813
Parks&Recreation FEB - 9 2015
i
Monon Community Center = Nichol Kaplan Hm Ph: (317) -
Carmel IN 46032 13801 Palo Alto Ct
Carmel IN 46074 Cell Ph:(317)523-6444
nmkaplan@mac.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 45.00- 45.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 45.00
Processed on 02/09/15 @ 14:26:06 by JAB NEW REFUND AMOUNT(-) 45.00
TOTAL REFUNDABLE AMOUNT 45.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 45.00 Made By==>REFUND FINAN With Reference=_>low enrollment;81-99-4358400 refund
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
0
i Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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.
Kaplan, Nichol Terms
13801 Palo Alto Ct Date Due
Carmel, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/9/15 1403667 Refund $ 45.00
I
Total $ 45.00
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.
Kaplan, Nichol Allowed 20
13801 Palo Alto Ct
Carmel, IN 46074
In Sum of$
$ 45.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#orBoard Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
1081-99 1403667 4358400 $ 45.00 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
February 12, 2015
Signature
$ 45.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund