HomeMy WebLinkAbout249218 09/09/15 Cqq.
4y,.. ":f. CITY OF CARMEL, INDIANA VENDOR: 369807
® ONE CIVIC SQUARE ALYSIA COULMONT CHECK AMOUNT: $ ...*"*30.00*
f' ?� CARMEL, INDIANA 46032 5876 E 1 26S ST CHECK NUMBER: 249218
'M�,roN ca, CARMEL IN 46033 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 30.00 REFUNDS AWARDS & INDE
Receipt#2000122.004 Page 1 of 1
i
N 0 2015
Monon Community Center West Voucher #2000122.004
Building Sep 1, 2015 10:02 AM
1195 Central Park Dr. West
Carmel, IN 46032
Phone: (317) 848-7275
FAX: - Cai 1 1 lei I* Clay
-
Email: info@carmelclayparks.comIff"11111,
arks&Recreation
NATIONAL GOLD MEDAL WINNER
ALYSIACOULMONT AND ACCREDITED /AGENCY
5876 EAST 126 ST
CARMEL, IN 46033
Prepared By: leahw
Customer ID: 22417
Primary phone: (317) 566-0729, Secondary phone: (317) 508-6931
Refund Summary
Check: ($30.00) Check #
Total Received: ($30.00) Total Refund: ($30.00)
Transactions
Customer Description Item Unit Qty Fee Charge
Gabrielle Coulmont Parent/Child Level 1-Swim Lessons#253100-02 Activity Fee Each 1.00 $30.00 ($30.00)
5876 East 126 st Action: Withdraw
Carmel,IN 46033 Withdrawal Date: Sep 1, 2015
Primary phone:(317)566-
0729 Meets: From September 2, 2015 to September 23,
Email:-- 2015
ID:22419 Each Wednesday from 6pm to 6:30pm
Location: Activity Pool 1 at
Monon Community Center West Building
Total Charges ($30.00)
Total Payments ($30.00)
Balance $0
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911 12G15
https://activenet023.active.com/carmeIclayparks/servlet/processReceiptPayment.sdi 9/1/2015
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.
Coulmont, Alysia Terms
5876 East 126 St Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/1/15 2000122004 Refund $ 30.00
Total $ 30.00
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
120
Clerk-Treasurer
i
Voucher No. Warrant No.
Coulmont, Alysia Allowed 20
5876 East 126 St
Carmel, IN 46033
In Sum of$
$ 30.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-10 2000122004 4358400 $ 30.00 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
September 4, 2015
Signature
$ 30.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund