256824 03/29/16 �%'�1p''�• CITY OF CARMEL, INDIANA VENDOR: 370457
® �; ONE CIVIC SQUARE JUDY STUSRUD CHECK AMOUNT: $********50.00*
,9 ,r�; CARMEL, INDIANA 46032 1537 BREWSTER ROAD CHECK NUMBER: 256824
''��'ro`ri�E°' INDIANAPOLIS IN 46260 CHECK DATE: 03/29/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 200065503 50.00 REFUNDS AWARDS & INDE
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.
Stusrud, Judy Terms
1537 Brewster Road Date Due
Indianapolis, IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/21/16 200065503 Refund $ 50.00
Total $ 50.00
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.
Stusrud, Judy Allowed 20
1537 Brewster Road
Indianapolis, IN 46260
',In Sum of$
$ 60.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
i.
PO#orBoard Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1096-40 200065503 4358400 $ 50.00 1 hereby certify that the attached invoice(s), or
bills)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
March 23, 2016
Signature
1 7 $ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Receipt#2000655.003 Page 1 of 1
MAu 2 2 L2016
Monon Community Center East
Building IES Y: ____ V-
P—?uch.er �#20.00655:00 ,
tMar,�21,;20T,&-17,.--52,-'P,M;
1235 Central Park Dr. East �:�:� 6w
Carmel, IN 46032
Phone: (317) 848-7275
FAX: -- Car Clay
Email. info@carmelclayparks.com
Parks&Recreation
a NATIONAL GOLD MEDAL WINNER
JUDYBREWsTUSRu:D AND ACCREDITED AGENCY
1�537�, STERt RQAD.�'
PN DIA APO LI S„I N 46266-,
Prepared By: amandaj
Customer ID: 28359
Primary phone: (317) 289-8906, Secondary phone: (317) 875-6067
Refund Summary
Check: rN1 1$50.00) Check #
Total Received: ($50.00) 71otal�Refund: '`($50`00)' ._
Transactions
Customer Description Item Unit Qty Fee Charge
Judy stusrud Pickleball for Beginners#367010-03 Activity Each 1.00 $50.00 ($50.00)
1537 Brewster Road- Action:Withdraw Fee
.Indianapolis,IN 46260 Withdrawal Date: Mar 21, 2016
Primary phone:(317)289-
8906 Meets: From March 31, 2016 to April 21, 2016
Email:rstus@comcast.net Each Thursday from 5:15pm to 6:45pm
ID:28359 Location:
Gymnasium B at Monon Community Center West Building
Total Charges ($50.00)
Total Payments ($50.00)
Balance $0
l b� b 40 g35f 40
https://anprod.active.com/cannelclayparks/servlet/processReceiptpayment.sdi 3/21/2016