249275 09/09/15 �"r C�HM
t CITY OF CARMEL, INDIANA VENDOR: 369810
(; ® i. ONE CIVIC SQUARE MARLENE GRIEF CHECK AMOUNT: $****.....8.00*
s a° CARMEL, INDIANA 46032 9256 WEST POINT DR CHECK NUMBER: 249275
9M TpN LA` INDIANAPOLIS IN 46268 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 8.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt# 1457485
Carmel a Clay Payment Date: 08/25/15
,J Household #: 24966
Parks&Recreation 7AUG
6 2015 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 8.00
Enrollee Name: Jessica Grief Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 158080-25 Adaptive Flowrider 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/13/2015 (Cancelled) _
Class Location: Flowrider Class Dates: 08/24/2015 to 08/24/2015
MC Outdoor Aquatics 5:30P to 7:OOP
M
Carmel, IN 46032 Scheduled Sessions: 1
Cancel Reason: Visit Refund
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/25/15 @ 11:43:08 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 8.00-
NET AMOUNT FROM CANCELLED ITEMS 8.00-
TOTAL AMOUNT REFUNDED 8.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 8.00 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.
20 9/"C4 LOARM 2&:LP t-5-
Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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Page# 1 of 1
I
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
8/25/15 1457485 Refund $ 8.00
Total $ 8.00
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
Voucher No. Warrant No.
Grief, Marlene Allowed 20
9256 West Point Dr
Indianapolis, IN 46268
In Sum of$
$ 8.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
4358400 $ 8.00 I hereby certify that the attached invoice(s), or
1096-70 1457485
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
$ 8.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund