HomeMy WebLinkAbout254112 02/05/16 W 4�q"
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�i ,f. CITY OF CARMEL, INDIANA VENDOR: 370273
® ONE CIVIC SQUARE ADRIAN MURPHY CHECK AMOUNT: $********75.00*
s9\ ;?q; CARMEL, INDIANA 46032 6031 CLEARVIEW DRIVE CHECK NUMBER: 254112
M�1ron�°' CARMEL IN 46033 CHECK DATE: 02/05/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 2000146.006 75.00 REFUNDS AWARDS & INDE
I
Voucher No. Warrant No.
Murphy, Adrian Allowed 20
6031 Clearview Drive
Carmel, IN 46033
In Sum of$
$ 75.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
I
PO#or INVOICE NO. ACCT#/TITLE AMOUNT 1 Board Members
Dept#
1092 2000146006 4358400 $ 75.00 1 hereby certify that the attached invoice(s), or
bill(s)is(are)true and correct and that the
imaterials or services itemized thereon for
- , - _ which charge is made were ordered and
�eceived except
January 28, 2016
Signature
Accounts Payable Coordinator
Title
7.
I
Receipt#2000146.006 Page 1 of 1
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Administrative offices VL
JAN 2 5 2016 I'VOUCh� # 0`001460'06 '
1411 E. 116th Street an 22, 2016 12 51 PM
Carmel, IN 46032
Phone_ (317) 843-3875 F I
CaM' �e- k Cl V
Email:
info@carmelclayparks.com Parks&Recreation
NATIONAL GOLD MEDAL WINNER
ADRIAN�;MURP_�iY, `T_, ''� AND. ACCREDITEDAGENCY
6031 CLEARVIEW�DRIUE `� (
A�RMEL,„IN%4=60,33
` R � a. Prepared By: mattw
Customer.ID: 5048
Primary phone: (317) 531-8415, Secondary phone: (317) 531-8415
Refund Summary
Check
Total Received: ($75.00) Total Refund: ($75.00)
Transactions
Customer Description Item Unit Qty Fee Charge
Donald Murphy Escape Pass-Adult Monthly Membership Each 1.00 $40.00 ($40.00)
6031 Clearview Drive Action: Membership Cancel Fee
Carmel,IN 46033 Expires: Jan 8, 2016
Primary phone:(317)531- Pass# 130037604: Donald Murphy
8415 Thanks for your purchase!This pass will
Email: automatically renew each month, until cancellation
adrian.murphy@saa.gov request is received. Cancellation request must be
ID:5047 received 7 days prior to billing date.
Donald Murphy Escape Pass-Adult Monthly Membership Each 1.00 $35.00 ($35.00)
6031 Clearview Drive Action: Membership Refund Fee
Carmel,IN 46033 Expires:Jan 8, 2016
Primary phone:(317)531- Pass# 130037604: Donald Murphy
8415 Thanks for your purchase!This pass will
Email: automatically renew each month, until cancellation
adrian.murphy@saa.gov request is received. Cancellation request must be
ID:5047 received 7 days prior to billing date.
Total Charges ($75:00)
�)
Total IPayments7a�5-'.0.0
Balance $0
Federal Tax ID # 35-6000972
109 .- ��5 8�too
https:Hactivenet023.active.com/carmelclayparks/servlet/processReceiptPayment.sdi 1/22/2016