248083 07/28/15 CITY OF CARMEL, INDIANA VENDOR: 369671
® it ONE CIVIC SQUARE ANTHONY WEAVER CHECK AMOUNT: $ """"57.50'
CARMEL, INDIANA 46032 8810 SUGAR CAY CT CHECK NUMBER: 248083
ZIONSVILLE IN 46077 CHECK DATE: 07/28/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 57.50 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1455881
Carni,el @ Clay Payment Date: 07/15/15
ParksAecreatoon Household#: 64641
Monon Community Center Anthony Weaver Hm Ph: (586)610-6541
Carmel IN 46032 8810 Sugar Cay Ct.
Zionsville IN 46077 Cell Ph:
Iittlewonders@me.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 57.50
Enrollee Name: Zoe Weaver Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 158060-03 Adaptive Swim Lesson 57.50 0.00 0.00 57.50 0.00
Enrollment Date: 06/22/2015 (Cancelled)
Class Location: Indoor Leisure Pool Class Dates: 07/01/2015 to 07/31/2015
Monon Community Cntr 12:OOA to 12:OOA
Mon thru Sun
Carmel, IN 46032 Scheduled Sessions: 31
(317)848-7275
Cancel Reason: Visit Refund
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/15/15 @ 15:44:36 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 115.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES() 57.50-
NET AMOUNT FROM CANCELLED ITEMS 57.50-
TOTAL AMOUNT REFUNDED 57.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 57.50 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.
f /
Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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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.
Weaver, Anthony Terms
8810 Sugar Cay Ct Date Due
Zionsville, IN 46077
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/15/15 1455881 Refund $ 57.50
Total $ 57.50
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Weaver, Anthony Allowed 20
8810 Sugar Cay Ct
Zionsville, IN 46077
In Sum of$
$ 57.50
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept#
1096-70 1455881 4358400 $ 57.50 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
July 23, 2015
IPAM"VA"
Signature
$ 57.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund