258659 05/13/16 0�'/ \� CITY OF CARMEL, INDIANA VENDOR: 370611
® ��
ONE CIVIC SQUARE MAX MCKASSON CHECK AMOUNT: $********85.00*
s. ,?�; CARMEL, INDIANA 46032 1580 WEST MAIN STREET CHECK NUMBER: 258659
�M;«oN CARMEL IN 46032 CHECK DATE: 05/13/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 2000788003 85.00 REFUNDS AWARDS & INDE
Voucher No. Warrant No.
McKasson, Max Allowed 20
1580 West Main Street
Carmel, IN 46032
In Sum of$
$ 85.00
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-10 2000788003 4358400 $ 85.00 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
May 6, 2016
V&Wlpy�
Signature
$ 85.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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.
McKasson, Max Terms
1580 West Main Street
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
5/4/16 2000788003 Refund $ 85.00
Total $ 85.00
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
5/4/2016 Receipt#2000788.003
l
Monon Community Center East Building
s �P: '`
,� -,r � .....� Voucher #20007:88.003
CE ,
1235 Central Park Dr. East �- =May4,r2016 1y 20 PM -7
Carmel, IN 46032 MAY - 6 2016
Phone: (317) 848-7275
FAX: -- BY: armel
Email: info@carmelclayparks.com
Parks;&Recreation
MAX MCKASSON _ -3 NATIONAL GOLD MEDAL IMINE
580 E T MAI N=.STREETS A N D ACCREDITED G E N C'.Y
Jy
CARMEL, IN�46032 f
�u Prepared By: leahw
Customer ID: 44112
Primary phone: (317) 670-6282, Secondary phone: --
Refund Summary
Cfae ,__ ,( 85f0JwC�leck # .
Total Received: ($85.00) Total Refund: ($85.00)
Transactions
Customer Description Item Unit Qty Fee Charge
Max McKasson Lifeguard Recertification #163123-02 Activity Each 1.00 $85.00 ($85.00)
1580 West Main Street Action: Withdraw Fee
Carmel, IN 46032 Withdrawal Date: May 4,2016
Primary phone: (317) 670-
6282 Meets: May 4,2016
Email: Wednesday from 4pm to 10pm
maxmmckasson@gmail.com Location:
ID: 44112 Party Room C at Monon Community Center West Building
Total Charges ($85.00)
Total Payments ($85.00)
Balance $0
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