250303 10/07/15 *f• - CITY OF CARMEL, INDIANA VENDOR: 369937
® 'il ONE CIVIC SQUARE JAMES JONES CHECK AMOUNT: S""""'"""47.00'
i4 CARMEL, INDIANA 46032 1373 KIRKLEES DR CHECK NUMBER: 250303
CARMEL IN 46032 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 47.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1458114
Carmel e lay Payment Date: 09/29/15
Parks&Recreation Household #: 57504
Monon Community Center SEP 1 9 2015 f James (Jay)Jones Hm Ph: (317)564-4298
Carmel IN 46032 I 1373 Kirklees Drive Wk Ph: (317) -
$Y: j Carmel IN 46032 Cell Ph:(407)608-0208
---- stetsonvol@hotmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 47.00
Enrollee Name: Alex Jones Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001-19 Play On 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 01/02/2015 (Cancelled)
Class Location: Creekside Middle Sch Class Dates: 07/27/2015 to 07/31/2015
Creekside Middle Sch 7:OOA to 6:OOP
3525 W. 126th Street M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)848-7275
cancel Reason: parent request
The following item reflects a payment towards a previous receipt
Enrollee Name: Alex Jones Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001-11 Play On 180.00 0.00 162.00 18.00 0.00
Enrollment Date:* 01/02/2015 (Enrolled)
Class Location: Creekside Middle Sch Class Dates: 06/01/2015 to 06/05/2015
Creekside Middle Sch 7:OOA to 6:OOP
3525 W. 126th Street M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)848-7275
Skip Days 07/04/2013
Special Questions: Child's T-Shirt Size?: YM
Child's Swimming Level?: Int
The following item reflects a payment towards a previous receipt
Enrollee Name: Alex Jones Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001-12 Play On 180.00 0.00 162.00 18.00 0.00
Enrollment Date: 01/02/2015 (Enrolled)
Class Location: Creekside Middle Sch Class Dates: 06/08/2015 to 06/12/2015
Creekside Middle Sch 7:OOA to 6:OOP
3525 W. 126th Street M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)848-7275
Special Questions: Child's T-Shirt Size?: YM
Child's Swimming Level?: Int
The following item reflects a payment towards a previous receipt
Enrollee Name: Alex Jones Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001-14 Play On 180.00 0.00 162.00 18.00 0.00
Enrollment Date: 01/02/2015 (Enrolled)
Page# 1 of 3
GLOBAL REFUND RECEIPT
CarmePa
l IE Receipt# 1458114
ec
rks& reation Payment Date: 09/29/2015
Household #: 57504
Class Location: Creekside Middle Sch Class Dates: 06/22/2015 to 06/26/2015
Creekside Middle Sch 7:OOA to 6:OOP
3525 W. 126th Street M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)848-7275
Special Questions: Child's T-Shirt Size?: YM
Child's Swimming Level?: Int
The following item reflects a payment towards a previous receipt
Enrollee Name: Alex Jones Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001-16 Play On 180.00 0.00 162.00 18.00 0.00
Enrollment Date: 01/02/2015 (Enrolled)
Class Location: Creekside Middle Sch Class Dates: 07/06/2015 to 07/10/2015
Creekside Middle Sch 7:OOA to 6:OOP
3525 W. 126th Street M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)848-7275
Special Questions: Child's T-Shirt Size?: YM
Child's Swimming Level?: Int
The following item reflects a payment towards a previous receipt
Enrollee Name: Alex Jones Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476006-07 Science of Summer 180.00 0.00 162.00 18.00 0.00
Enrollment Date: 01/26/2015 (Enrolled)
Class Location: Program Rms A, B, C Class Dates: 07/13/2015 to 07/17/2015
Monon Community Cntr 8:OOA to 5:30P
M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)848-7275
Special Questions: Child's T-Shirt Size?:
Child's Swimming Level?:
The following item reflects a payment towards a previous receipt
Enrollee Name: Alex Jones Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476006-08 Science of Summer 180.00 0.00 162.00 18.00 0.00
Enrollment Date: 03/31/2015 (Enrolled)
Class Location: Program Rms A, B, C Class Dates: 07/20/2015 to 07/24/2015
Monon Community Cntr 8:OOA to 5:30P
M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)848-7275
Special Questions: Child's T-Shirt Size?:
Child's Swimming Level?:
PREVIOUS NET HOUSEHOLD BALANCE 126.00
Processed on 09/29/15 @ 13:08:29 by JAB FEES CHANGED ON CANCELLED ITEMS(+) 180.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 7.00-
NET AMOUNT FROM CANCELLED ITEMS 17
FEES ADJUSTED ON CHANGED ITEMS(+) 0.00
NET AMOUNT FROM CHANGED ITEMS 0.00
Page# 2 of 3
'
Carmel o Clay GLOBAL REFUND RECEIPT
rte. Receipt# 1458114
Irks&Recreaboh Payment Date: 09/29/2015
Household #: 57504
HH BALANCE APPLIED TO THIS RECEIPT(+) 126.00
TOTAL AMOUNT REFUNDED 47.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 47.00 Made By==>REFUND FINAN With Reference==>parent request;82-11-4358400 refund
Payment of==> 108.00 Made By==> Activity Registration Credit Balance
All ref s are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
i ed.
thorized S gnature Date Authorized Signature Date
L,-)
Escape Day Passes are non-refundable.
Page# 3 of 3
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.
Jones, James Terms
1373 Kirklees Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/29/15 1458114 Refund $ 47.00
Total $ 47.00
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.
Jones, James Allowed 20
1373 Kirklees Drive
Carmel, IN 46032
In Sum of$
$ 47.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1082-11 1458114 4358400 $ 47.00 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
October 1, 2015
Signature
$ 47.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund