HomeMy WebLinkAbout304868 11/03/16 (9,
CITY OF CARMEL, INDIANA VENDOR: 371289
ONE CIVIC SQUARE ED SHAW CHECK AMOUNT: S 42.62CARMEL, INDIANA 46032 2015 E 109TH ST CHECK NUMBER: 304868
INDIANAPOLIS IN 46280 CHECK DATE: 11/03/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 2000458004 42.62 REFUNDS AWARDS & INDE
Voucher No. Warrant No.
Shaw, Ed Allowed 20
2015 E 109th St
Indianapolis, In 46280
In Sum of$
$ 42.62
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#!TITLE AMOUNT Board Members
Dept#
1092 2000458004 4358400 $ 42.62 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
November 1, 2016
Signature
$ 42.62 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Receipt#2000458.004 R�E ,,, lI T,7 Page 1 of 1
OCT 2 42016
Monon Community Cente s =—=_ Vo
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Building CZct�21,�2Q612`„0,9, P,M
1195 Central Park Dr. West
Carmel, IN 46032
Phone: (317) 848-7275
FAX: -- Car
Email: info@carmelclayparks.com
Parks&Recreation
NATIONAL GILD MEDAL WINNER
71,
41--, 1.
Z. ,�..1.o9T�ls1 AND ACCREDITED AGENCY
LI-NDIANAPO ILIL S,aN 264 0
Prepared By: prestons
Customer ID: 10463
Primary phone: (317) 843-0086, Secondary phone: --
Refund Summary
Check: ($42.62) Check #
Total Received: ($42.62) Total Refund: ($42.62)
Transactions
Customer Description Item Unit Qty Fee Charge
Elaine Shaw Escape Pass-Senior Annual (Legacy)
2015 E.109th St. Action: Membership Cancel Membership Each 1.00 $42.62 ($42.62)
Fee
Indianapolis,IN 46280 Expires: Dec 12, 2015
Primary phone:(317)843- Pass# 130031038: Elaine Shaw
0086 Thanks for your purchase!
Email:
elaineshaw7@gmail.com
ID: 10461
Total Charges ($42.62)
ota'I�Paynten1Eg ($4,2:62)--
Balance $0
Federal Tax ID # 35-6000972
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