243215 3 /18/2015 o
CITY OF CARMEL, INDIANA VENDOR: 367623ONE CIVIC SQUARE MARLENE GRIEFCHECKAMOUNT: S*'***"'*15.00*
CARMEL, INDIANA 46032 9256 WEST POINT DR CHECK NUMBER: 243215
INDIANAPOLIS IN 46266 CHECK DATE: 03/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 1418250 15.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1418250
Carmel * C a --� Payment Date: 03/11/15
rksAecrcation MAR 12 2015 Household#: 24966
Monon Community Center Marlene Grief Hm Ph: (317)876-7921
Carmel IN 46032 9256 West Point Dr. Wk Ph: (317) -
Indianapolis IN 46268 Cell Ph:(317)840-2170
rsgrief@yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 15.00
Enrollee Name: Jessica Grief Fees+Tax Discount Prey Paid Cur Paid Amount Due
Activity Number: 358032-03 Fantastic Friday 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/01/2014 (Cancelled)
Class Location: Party Rooms A&B Class Dates: 03/13/2015 to 03/13/2015
Monon Community Cntr 6:OOP to 8:30P
F
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: Guest Request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 03/11/15 @ 17:54:30 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 15.00-
NET AMOUNT FROM CANCELLED ITEMS 15.00-
TOTAL AMOUNT REFUNDED 15.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 15.00 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.
,110 311 qUE
Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
/n 0
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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.
Grief, Marlene Terms
9256 West Point Dr Date Due
Indianapolis, IN 46268
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/11/15 1418250 Refund $ 15.00
Total $ 15.00
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.
Grief, Marlene Illowed 20
9256 West Point Dr
Indianapolis, IN 46268
In Sum of$ -
I,
$ 15.00
ON ACCOUNT OF APPROPRIATION FOR I
109 -MCC
PO#or . INVOICE NO. ACCT#/TITL AMOUNT N, Board Members
Dept#
1092 1418250 4358400 $ 15.00 IIhereby certify that the attached invoice(s), or
t ill(s)is(are)true and correct and that the
materials or services itemized thereon for
�.,
y hich charge is made were ordered and
received except
z
II,
March 13, 2015
1
Signature
$ 15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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