251502 11/18/15 ,_CSA .
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CITY OF CARMEL, INDIANA VENDOR: 370063
d l ONE CIVIC SQUARE ELLIE CRANE CHECK AMOUNT: $**......10.00*
r. ?4 CARMEL, INDIANA 46032 1049 BRISTOL ROAD CHECK NUMBER: 251502
M_roN�. INDIANAPOLIS IN 46280 CHECK DATE: 11/16/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 = 10.00 REFUNDS AWARDS & INDE
11/2/2015R� .CE77 116.006
Administrative Offices NOV - 4 2015 Voucher #2000116.006
1411 E. 116th Street Nov 2, 2015 3:33 PM
Carmel, IN 46032 BY:
Phone: (317) 843-3875
FAX: - do—ftfm% 10% IL ff
-
Email: info@carmelclayparks.com Carl 11 Co* 10C I TA AV
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ar s&Recreation
ELLIE CRANE NATIONAL GOLD MEDAL WINNER
1049 BRISTOL ROAD
INDIANAPOLIS, IN 46280 AND ACCREDITED AGENCY
Prepared By: michelley
Customer ID: 22686
Primary phone: (317) 501-8358, Secondary phone: --
Refund Summary
Check: ($10.00) Check #
Total Received: ($10.00) Total Refund: ($10.00)
Transactions -�
-Customer - - Descriptimro - Iterii . Unit --Qty -Fee Charge
Londa Crane Adaptive Masquerade Sall #358050-01 Activity Fee Each 1.00 $10.00
1049 Bristol Road Action: Withdraw
Indianapolis, IN 46280 Withdrawal Date: Nov 2,2015
Primary phone: (317) 501-
8358 Meets: October 30,2015
Email: -- Friday from 6pm to Bpm
ID: 13410 Location: Multipurpose Room East C at
Monon Community Center East Building
Multipurpose Room East B at
Monon Community Center East Building
Multipurpose Room East A at
Monon Community Center East Building
Total Charges ($10.00)
Total Payments ($10.00)
Balance $0 �
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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.
Crane, Ellie Terms
1049 Bristol Road Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/2/15 2000116006 Refund $ 10.00
I
Total $ 10.00
I 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.
Crane, Ellie Allowed 20
1049 Bristol Road
Indianapolis, IN 46280
In Sum of$
$ 10.00 _
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-70 2000116006 4358400 $ 10.00 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
November 4, 2015
Signature
$ 10.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund