257630 04/15/16 CITY OF CARMEL, INDIANA VENDOR: 370523
G® � ONE CIVIC SQUARE JESSICA HOLLENBECK CHECK AMOUNT: $*******173.00*
:. �� CARMEL, INDIANA 46032 4693 CHEVEL PLACE CHECK NUMBER: 257630
o.�,�iTON�` CARMEL IN 46033 CHECK DATE: 04/15/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 200009429 173.00 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.
Hollenbeck, Jessica Terms
4693 Cheval Place Date Due
Carmel, IN 46033
invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/6/16 200009429 Refund $ 173.00
Total Is 173.00
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
Receipt 92000094.029 Page 1 of 1
APR 6 2016
Smoky Row Elementary VOucl*V#�206009'4:0239
900 w 136th Street BY: A r 6, 201;6 8 49 A
Carmel, IN 46032
Phone: (317) 418-6917
FAX: -- -
Email: info@carmelclayparks.com I. i h a
Parks& ceea i n
�-HL`L-:-NB7 CJESSICAra ,_.�. NATIONAL- GOLMEDAL VtVCEt
4693 CH VE AL,PLAGE'
AND
ACCREDITED GENCY
CARMEL;:,IN 4:6
Prepared By: amyb
Customer ID: 19897
Primary phone: .(317) 669-2868, Secondary phone: (317) 645-6868-
Refund Summary
Check: 4%qZ—;iG&--)Cah-eek #
Total Received: ($173.00) TotalRefu'nd"`~
Transactions
Customer Description Item Unit Qty Fee Charge
Elena Porter Science of Summer(Wk 9-Goopity Goo) #476006- Activity Fee Each 1.00 $173.00 ($173.00)
4693 Cheval Place 09
Carmel,IN 46033 Action:Withdraw
Primary phone:.(317)669- Withdrawal Date: Apr 6,2016
2868
Email: Meets: From July 25, 2016 to 3uly'29,2016
jjhollenbeck@lCloud.com Each Monday from Sam to 5:30pm
ID: 19900 Each Tuesday from Sam to 5:30pm
Each Wednesday.from Sam to 5:30pm
Each Thursday from Sam to 5:30pm
Each Friday from Sam to 5:30pm
Location: Program Room B at Monon Community
Center-East Building
Program Room C at Monon Community Center East
Building
Total`Clarges=($17300)°
Total Payments ($173.00).
Balance $0
e4tefund)
,SZgnature:
®ate.
https://anprod.active.com/carmelclayparks/servlet/ShowReceipt.sdi?receiptheader_id=2143... 4/6/2016