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301273 07/28/16 .4�Yr 44q�F CITY OF CARMEL, INDIANA VENDOR: 370915 CHECK AMOUNT: $***'* *`40.00' .� ® ONE CIVIC SQUARE GREG KRONTIRIS CARMEL, INDIANA 46032 5136 ORIOLE CHECK NUMBER: 301273 CARMEL IN 46033 CHECK DATE: 07/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 2000344004 40.00 REFUNDS AWARDS & INDE Voucher No. Warrant No. Krontiris, Greg Allowed 20 5136 Oriole Carmel, IN 46033 In Sum of$ $ 40.00 ON ACCOUNT OF APPROPRIATION FOR 109 -MCC PO#or INVOICE NO. ACCT#!TITLE AMOUNT Board Members Dept# 1092 2000344004 4358400 $ 40.00 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 July 22, 2016 'PAdimm" Signature $ 40.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund Receipt#2000344.004 Page 1 of 1 CEIVED JUL 21'2016 Monon Community Center We ouches=<r:#.2000344.004 Building ]ul 1.9, 201;6 3 50YPM 1195 Central Park Dr. West _ Carmel, IN 46032 Phone: (317) 848-7275 FAX: -- Carmel 9 Clay Email: info@carmelclayparks.com Parks&Recreation NATIONAL GOLD MEDAL WINNER. GREG }�RONTIRIS 5%36OtRPo E „r AND ACCREDITED AGENCY CARMEL, IN 46033.. Prepared By: hollypg Customer ID: 29384 Primary phone: (317) 571-1106, Secondary phone: (317) 571-1106 Refund Summary _ __.r 4iheck:.�($4d 00)-Check-#------ J' Total Received: ($40.00) Total Refund: ($40.00) Transactions Customer Description Item Unit Qty Fee Charge Greg Krontiris Escape Pass-Adult Monthly Membership Each 1.00 $40.00 ($40.00) 5136 oriole Action: Membership Cancel Fee Carmel,IN 46033 Expires: Jul 19, 2016 Primary phone:(317)571- Pass# 130040688: Greg Krontiris 1106 Thanks for your purchase!This pass will Email:Gkrontiris@indy.rr.com automatically renew each month, until cancellation ID:29384 request is received. Cancellation request must be received 7 days prior to billing date. _Total Charges ($40.00) Total-Payments Balance $0 Federal Tax ID # 35-6000972 \0 CIO https:Hanprod.active.com/carinelclayparks/servlet/processReceiptPayment.sdi 7/19/2016