247038 06/30/1 5 CITY OF CARMEL, INDIANA VENDOR: 369530
® ONE CIVIC SQUARE NATASHA WILLIAMS CHECK AMOUNT: $********74.25*
CARMEL, INDIANA 46032 10125 CARROLTON AVE CHECK NUMBER: 247038
9y(i�N L�.a INDIANAPOLIS IN 46280 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 74.25 REFUNDS AWARDS & INDE
Receipt#2000028.004 Page 1 of 1
JUN 19 2015
Monon Community Center Westa ; jVOUCI1e1' #2000028.004
Building V �
1195 Central Park Dr. West Jun 17, 2015 1:55 PM
Carmel, IN 46032
Phone: (317) 848-7275
FAX: - U �Iay
-
Email: info@carmelclayparks.com
ks& Kecrealtion
NATIONAL GOLD MEDAL WINNER
NATASHA WILLIAMS AND ACCREDITED C Y
10125 CARROLTON
AVENUE
INDIANAPOLIS, IN 46280
Prepared By: hollypg
Customer ID: 1639
Primary phone: (317) 844-3025, Secondary phone: --
Refund Summary
Check: ($74.25) Check #
Total Received: ($74.25) Total Refund.: ($74.25)
Transactions
Customer Description Item Unit Qty Fee Charge
Natasha Williams Escape Pass- Household Monthly Membership Each 1.00 $74.25 ($74.25)
10125 Carrolton Avenue Action: Membership Refund Fee
Indianapolis,IN 46280 Expires: Jun 15, 2015
Primary phone:(317)844- 10 Passes Sold
3025 Pass# 000003325: Addison Williams
Email: -- Pass# 000003326: Christopher Williams
ID: 1639 Pass# 130016030: Natasha Williams
Pass # 000003328: Tyler Williams
Thanks for your purchase!This pass will
automatically renew each month, until cancellation
request is received. Cancellation request must be
received 7 days prior to billing date.
Total Charges ($74.25)
Total Payments ($74.25)
Balance $0
https://activenet023.active.com/carmelclayparks/servlet/processReceiptPayment.sdi 6/17/2015
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.
Williams, Natasha Terms
10125 Carrolton Avenue Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/17/15 2000028004 Refund $ 74.25
1
Total $ 74.25
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.
Williams, Natasha Allowed 20
10125 Carrolton Avenue
Indianapolis, IN 46280
In Sum of$
$ 74.25
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 2000028004 4358400 $ 74.25 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
June 25, 2015
Signature
$ 74.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund