249652 09/23/15 ,Cq_q
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CITY OF CARMEL, INDIANA VENDOR: 369063
® I ONE CIVIC SQUARE SHELIA CRAWFORD CHECK AMOUNT: $ ......16.00`
f. =a CARMEL, INDIANA 46032 14150 BEN KINGSELY LANE CHECK NUMBER: 249652
9.y,roN.�. CARMEL IN 46033 CHECK DATE: 09/23/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 16.00 REFUNDS AWARDS & INDE
Receipt#2000135.004 Page 1 of 1
Monon Community Center West Voucher #2000135.004
Building Sep 11, 2015 11:07 AM
1195 Central Park Dr. West
Carmel, IN 46032
Phone: (317) 848-7275
FAX: -- Car el
Email: info@carmelclayparks.com y
Parks&Recreation
NATIONAL GOLD MEDAL WINNER
SHEILA CRAWFORD AND ACCREDITED AGENCY
14150 BEN KINGSLEY LANE
CARMEL, IN 46033
Prepared By: leahw
Customer ID: 24691
Primary phone: (773) 315-5518, Secondary phone: (773) 315-5518
Refund Summary
Check: ($16.00) Check #
Total Received: ($16.00) Total Refund: ($16.00)
Transactions
Customer Description Item Unit Qty Fee Charge
Claire Crawford Preschool Level 1- Swim Lessons #253102-01 Activity Fee Each 1.00 $46.00 ($46.00)
14150 Ben Kingsley Lane Action:Transfer Out
Carmel,IN 46033 Withdrawal Date: Sep 11, 2015
Primary phone:(773)315-
5518 Meets: From September 1, 2015 to September 22,
Email: 2015
sheilacrawford22@gmail.com Each Tuesday from 11am to 11:45am
ID: 24703 Location: Activity Pool 3 at
Monon Community Center West Building
Claire Crawford Parent/Child Level 1-Swim Lessons #253100-08 Activity Fee Per Seat 1.00 $30.00 $30.00
14150 Ben Kingsley Lane Action:Transfer In
Carmel,IN 46033 Enrollment Effective Date: Sep 11, 2015
Primary phone:(773)315-
5518 Meets: From October 10, 2015 to October 31, 2015
Email: Each Saturday from 9am to 9:30am
sheilacrawford22@gmail.com Location: Activity Pool 1 at
ID:24703 Monon Community Center West Building
Total Charges ($16.00)
o Total Payments ($16.00)
/ 9C. �o.u3Sgyoz>
Balance $0
q /11 hs
Activity Waiver ���` ey( (/(S
Waiver for:Claire Crawford
Activity Waiver & Disclaimer FEP015
i
Waiver Signed by:Sheila Crawford on Sep 11, 2015
littps:HactivenetO23.active.com/carmeIcIa),parks/servlet/processReceiptPayment.sdi 9/11/2015
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.
Crawford, Sheila Terms
14150 Ben Kingsley Lane Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/11/15 2000135004 Refund $ 16.00
Total $ 16.00
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
, 20
Clerk-Treasurer
Voucher No. Warrant No.
Crawford, Sheila Allowed 20
14150 Ben Kingsley Lane
Carmel, IN 46033
In Sum of$
$ 16.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITI- AMOUNT Board Members
Dept#
1096-10 2000135004 4358400 $ 16.00 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 17, 2015
'PAO"VA"
Signature
$ 16.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund