HomeMy WebLinkAbout258776 05/23/16 4 j .� CITY OF CARMEL, INDIANA VENDOR: 370566 ***w*+*
® ONE CIVIC SQUARE CHRISTINE LARSON CHECK AMOUNT: $ 99.00
:. =a CARMEL, INDIANA 46032 1484 STORMY RIDGE CT CHECK NUMBER: 258776
9�'idFmi c��9 CARMEL IN 46032 CHECK DATE: 05/23/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 2000257004 99.00 REFUNDS AWARDS & INDE
toucher No. Warrant No.
Larson, Christine Allowed 20____
1484 Stormy RidgeCt
Carmel, IN 46032
ONACCOUNT OF APPROPRIATION FOR
109-MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 2000257004 4358400 $ 99.00 | hereby certify that the attached invoiva(a). or
biU(s) io(one)true and correct and that the
materials orservices itemized thereon for
which charge immade were ordered and
received except
'
April
27 2016
signature
Accounts Pb|aCoordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be property 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.
Larson, Christine Terms
1484 Stormy Ridge Ct Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/25/16 2000257004 Refund $ 99.00
Total $ 99.00
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#2000257.004 � ''�%r�: �. ; Page 1 of 1
APR 2 7 ��16
BY:
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Monon Community Center
Vouc�ier.��#2000.25�7.004�..
West Building -Apr 25—20.1.6,4, PM
1195 Central Park Dr. West -
Carmel, IN 46032
Phone: (317) 848-7275
FAX: -- Carmel I
Email. info@carmelclayparks.com Parks&Recreation
{.� [NATIONAL GOLD MEDAL WINNER
CHRbSTINE CARSON
1�4$4f�S tQRMY�RIDGE CT AND ACCREDITED AGENCY
® EL�-;IN 4;6'032
Prepared By: prestons
Customer ID: 13766
Primary phone: (317) 844-4279, Secondary phone: (317) 844-4279
Refund Summary
`Check _ ($':99:00eck #
Total Received: ($99.00) Total Refund: ($99.00)
Transactions
Customer Description Item Unit Qty Fee Charge
Christine Larson Escape Pass- Household Monthly Membership Each 1.00 $99.00 ($99.00)
1484 stormy Ridge Ct. Action: Membership Cancel Fee
Carmel,IN 46032 Expires: Apr 10, 2016
Primary phone:(317)844- 15 Passes Sold
4279 Pass # 130031235: Christine Larson
Email: Thanks for your purchase!This pass will
kclarson5@sbcglobal.net automatically renew each month, until cancellation
ID:13766 request is received. Cancellation request must be
received 7 days prior to billing date.
Total Charges ($99.00)
9T-ota;I Pay"meir`ESOT z 99"0
Balance $0
Federal Tax ID # 35-6000972
oma