245092 5 /13/2015 y w..4�q,�
�/ �F� CITY OF CARMEL, INDIANA VENDOR: 369348
® �J ONE CIVIC SQUARE VICKI CUMMINGS CHECK AMOUNT: $*********3.20"
r. _� CARMEL, INDIANA 46032 44 SHERMAN DRIVE CHECK NUMBER: 245092
,,y., CARMEL IN 46032 CHECK DATE: 05/13/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1439155 3.20 REFUNDS AWARDS & INDE
'a
GLOBAL REFUND RECEIPT
armee * �? Payment
1439155
Pa ment Date: 04/22/15
Parks&Reereaboh Household#: 231
Monon Community Center Vicki Cummings Hm Ph: 317)844-8898
Carmel IN 46032 44 Sherman Drive Wk Ph: 317 849-0606
Carmel IN 46032 Cell Ph:(317)590-0891
vvcohana@indy.rr.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION
Pass Holder. Vicki Cummings _- Fees+Tax Discount Prey Paid Cur Paid Amount Due --
Pass Type: MC HH Mthly(M MCHHM),#281618 99.00 0.00 99.00 0.00 0.00
Valid Dates: 04/05/2015 to 04/05/2016 (Pass Cancellation)
Cancellation Effective: 04/22/2015
Cancel Reason: active
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 3.20
Processed on 04/22115 @ 17:53:58 by HPG FEES CHANGED ON CANCELLED ITEMS(+) 0.00
-NET.AMOUNT•FROM-.CANCELL'ED-ITEMS.-:':. 0.00
HH BALANCE APPLIED TO THIS RECEIPT•F 3.20-
TOTAL AMOUNT REFUNDED 3.20
NEW NET HOUSEHOLD BALANCE 0.00
Refund of==> 3.20 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 wilt be
issued.
y_: 4-1 J2711
Authorized ig ature ' Oak IAuthorized Signature Date
Escape Day Passes are non-refundable.
Page# 1 of 1
,'
ACTIVITY REFUND RECEIPT
Receipt# 881318
Carmel Clay Payment Date: 07/03/12
Forks&Recreation
Household#: 23.1
Monon Community Center Vicki Cummings Hm Ph:(317)844-8898
Carmel IN 46032 44 Sherman Drive Wk Ph: 317 849-0606
Carmel IN 46032 Cell Ph:
�317�590-0891
wcohana@indy.rr.com
Phone:{317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
_ ROSTER CHANGE-Refund Of 3,20
Enrollee Name; - -'•-Noah-Cummings-- — .w -Fees.-+_Tax--__--Discount--_-__P_rev_P_aid__-- Our Paid__Amount Due
Activity Number: 126120-01 Archery 12.80 0.00 12.80 0.00 0.00
Enrollment Date: 04/0112012 (Enrolled)
Primary Instructor. CCPR Staff
Class Location: West Park Field Class Dates: 05/24/2012 to 06/28/2012
West Park 4:30P to 5:15P
2700 W. 116th St. Th
Carmel, IN 46032 Scheduled Sessions: 5
(317)848-7275
Skip Days 06/07/2012
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/03/12 @ 09:58:56 by CNA FEES ADJUSTED ON CHANGED ITEMS(+) 3.20-
NI=T AMOUNTYROM`.CHANGED ITEMS .3,20-
TOTAL AMOUNT REFUNDED.- 3.20
NEW NET CREDIT HOUSEHOLD BALANCE 3.20
--- - Refund-of==> ---3:20--Made By-==>-SYSTEM-GL�NJilh-Reference==>-cancelled;heat----- -- -- --- —--- ___-- -_
Volunteer with Us!
Volunteers are the foundation of Carmel Clay Parks&Recreation and we need your help!We are currently seeking volunteers
for special events,adaptive programs, parks and greenways,and Extended School Enrichment. If interested,please call Dana
at 317.843.3868 or register online at https://2011cprv.theregistrationsystem.com/en/10331
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.
Cummings, Vicki Terms
44 Sherman Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/22/15 1439155 Refund $ 3.20
Total $ 3.20
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.
Cummings, Vicki Allowed 20
44 Sherman Drive i
Carmel, IN 46032
In Sum of$
$ 3.20
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
i
PO#or INVOICE NO. ACCT#ITITLE AMOUNT Board Members
Dept#
1096-42 1439155 4358400 $ 3.20 .I 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
May 4, 2015
i
Signature
$ 3.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i