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Home My WebLink About253691 01/22/16 ��'� `''° CITY OF CARMEL, INDIANA VENDOR: T356029 �! �,• ONE CIVIC SQUARE LAURA KOLIC CHECK AMOUNT: $*******304.00* 4� �a CARMEL, INDIANA 46032 5270 LAKE POINT DRIVE CHECK NUMBER: 253691 +��TON�� CARMEL IN 46033 CHECK DATE: 01/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 2000141006 304.00 REFUNDS AWARDS & INDE i Voucher No. Warrant No. Kolic, Laura Allowed 20 3059 Sugar Maple Court Carmel, IN 46033 i In Sum of$ $ 304.00 i , ON ACCOUNT OF APPROPRIATION FOR t 109 -MCC l i PO#or Board Members Dept# INVOICE NO. ACCT#/TITLE AMOUNT 1 1092 2000141006 4358400 $ 304.00 1 hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and that the i materials or services itemized thereon for which charge is made were ordered and received except t I I, January 18, 2016 I Signature $ 304.00 Accounts Payable Coordinator ,.Cost distribution ledger classification if Title claim paid motor vehicle highway fund I i i Receipt#2000141.006 Page 1 of 2 ],D,administrative OfficeJAN 14 Z 1411 E. 116th Street ,. -r Carmel, IN 46032 Phone: (317) 843-3875 FAX: -- Cla Emil: a y info@carmelclayparks.com ti-ionParks&Recrea' NATIONAL AND ACCREDITED AGENCY URA KOJ RAW 09�5�lJGA��.�PL G® RT�' CAR,MEi-,,IW460-33 Prepared By: mattw - - - Customer ID: 1558 Primary phone: (317) 716-6134, Secondary phone: -- Refund Summary •Me (+r$37,(RV@) Check # Total Received: ($304.00) Total Refund: ($304.00) I Transactions ..___....._...... ....._..__.._. Customer Description Item Unit Qty Fee Chargee Rick Kolic Escape Pass-Adult Monthly Membership Each 1.00 $38.00 ($38.00) 5270 Lake Point Dr. Action:Membership Cancel Fee Carmel,IN 46033 Expires: Dec 15,2015 Primary phone:(317)716- Pass# :1.30016719: Rick Kolic 6134 Thanks for your purchase!This pass will Email:Ikolic@yahooxom automatically renew each month, until cancellation ID:1556 request is received. Cancellation request must be received 7 days prior to billing date. Rick Kolic Escape Pass-Adult Monthly Membership Each 1.00 $38.00 ($38.00) 5270 Lake Point Dr. Action: Membership Refund Fee Carmel,IN 46033 Expires: Dec 15,2015 Primary phone:(317)716- Pass# 130016719: Rick Kolic 6134 Thanks for your purchase!This pass will Email:tkolic@yahoo.com automatically renew each month,until cancellation ID: 1556 request is received.Cancellation request must be received 7 days prior to billing date. Rick Kolic Escape Pass-Adult Monthly Membership Each 1.00 $38.00 ($38.00) 5270 Lake Point Dr. Action: Membership Refund Fee Carmel,IN 46033 Expires: Nov 15, 2015 Primary phone:(317)716- Pass# :130016719: Rick Kolic 6134 Thanks for your purchase!This pass will Email:Ikolic@yahoo.com automatically renew each month,until cancellation ID: 1556 request Is received.Cancellation request must be received 7 days prior to billing date. Rick Kobe Escape Pass-Adult Monthly Membership Each 1.00 $38.00 ($38.00) 5270 Lake Point Dr. Action: Membership Refund Fee Carmel,IN 46033 Expires: Oct 15, 2015 Primary phone:(317)716- Pass # 130016719: Rick Kolic 6134 Thanks for your purchase!This pass will Email:Ikolic@yahoo.com automatically renew each month, until cancellation ID:1556 request is received.Cancellation request must be received 7 days prior to billing date. Rick Kolic Escape Pass-Adult Monthly Membership Each 1.00 $38.00 ($38.00) 5270 Lake Point Dr. Action: Membership Refund Fee Carmel,IN 46033 Expires: Sep 15, 2015 Primary phone:(317)716- Pass # 130016719: Rick Kolic 6134 Thanks for your purchase!This pass will automatically renew each month, until cancellation https://activenet023.active.com/carmelclayparks/servlet/processReceiptPayment.sdi 1/8/2016 Receipt 92000141.006 Page 2 of 2 Email:lkolic@yahoo,com request is received. Cancellation request must be ID:1556 received 7 days prior to billing date. Rick Koiic Escape Pass-Adult Monthly Membership Each 1.00 $38.00 ($38.00) 5270 Lake Point Dr. Action: Membership Refund Fee Carmel,IN 46033 Expires: Aug 15,2015 Primary phone:(317)716- Pass# 1.30016719: Rick Kolic 6134 Thanks for your purchase!This pass will Email:lkollc@yahoo.com automatically renew each month,until cancellation ID:1556 request is received. Cancellation request must be received 7 days prior to billing date. Rick Kolic Escape Pass-Adult Monthly Membership Each 1.00 $38.00 ($38.00) 5270 Lake Point Dr. Action:Membership Refund Fee Carmel,IN 46033 Expires:Jut 15, 2015 Primary phone;(317)716- Pass# 130016719: Rick Kolic 6134 Thanks for your purchase!This pass will Email:lkolic@yahoo.com automatically renew each month,until cancellation ID:1556 request Is received.Cancellation request must be received 7 days prior to billing date. Rick Kolic Escape Pass-Adult Monthly Membership Each 1.00 $38.00 ($38.00) 5270 Lake Point Dr. Action:Membership Refund Fee Carmel,IN 46033 Expires: Jun 15, 2015 Primary phone:(317)716- Pass # 130016719: Rick Kolic 6134 Thanks for your purchase!This pass will Email:-Ikoilc@yaho`o.com automatically renew each month, until cancellation ID:1556 request is received.Cancellation request must be received 7 days prior to,billing date. Total Charges ($304.00) RIF AS --—.0-W-1 NOWN Balance $0 Federal Tax ID # 35-6000972 https:Hactivenet023.active.com/carmelelayparks/servlet/processReceiptPayment.sdi 1/8/2016