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307765 01/30/17 w�,°`� CITY OF CARMEL, INDIANA VENDOR: 362799 'Ja *:;, CHECK AMOUNT: $*"******88.00* ONE CIVIC SQUARE LEE COOLIDGE CARMEL, INDIANA 46032 799 BENNETT COURT CHECK NUMBER: 307765 � _ CARMEL IN 46032 CHECK DATE: 01/30/17 �SON DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 2000497004 88.00 REFUNDS AWARDS & INDE « C:) k 0 \ © - e f / 0 / f\ w m0 ) cok CO00 # K 2 ° 2 kCE � & co m ® ■ � M \ ( } k § co k o 2 $ r- q , # • . o # _ CD iCD m > 0 - ƒ S 0 0 2 N F J \ $ \ q ƒ � z ( P m% Z J > 0 $ \ a � . k k a ] E / \ o ° ƒ $ < _ \ - E & $ M ] q \ Q k 0o cD g ) k j 0 CD (D cn� @ E 2 \ k ) ƒ k I \ S \ 2 \ CD k k \ C) E n a / w 7 / k \ K § w k 7 A 7 C) ƒ � / / � � m m � | \ R Receipt-#2000497.004 Page 1 of 2 Monon Community Center West Voucher #2000497.004 Building Jan 24, 2017 9:27 AM 1195 Central Park Dr. West Carmel, IN 46032 Phone: (317) 848-7275 FAX: -- Car el o Clay Email: info@carmelclayparks.com ,� Pa�'I� &R�'Crec�tlorl NATIONAL GOLD MEDAL WINNER LEE COOLIDGBENNETT CT. AND ACCREDITED AGENCY 799 BENNE CARMEL, IN 46032 Prepared By: staceyl Customer ID: 4491 Primary phone: (317) 538-9441, Secondary phone: -- Refund Summary Check: ($88.00) Check # Total Received: ($88.00) Total Refund: ($88.00) Transactions Customer Description Item Unit Qty Fee Charge Lee Coolidge Escape Pass- Household Monthly Membership Each 1.00 $20.00 ($20.00) 799 Bennett Ct. Action: Membership Refund Fee Carmel,IN 46032 Expires: Aug 15,2016 Primary phone:(317)538- 15 Passes Sold 9441 Pass # 130002320: Lee Coolidge ) Email:Icooli@yahoo.com Pass # 130044744: Campbell Coolidge i ID:4491 Pass # 130034753: Clayton Coolidge j Pass # 130046029: Cooper Coolidge Pass # 000023641: Becky Coolidge Thanks for your purchase! This pass will ) BY: .............................. automatically renew each month, until cancellation request is received. Cancellation request must be received 7 days prior to billing date. Lee Coolidge Escape Pass- Household Monthly Membership Each 1.00 $20.00 ($20.00) 799 Bennett Ct. Action: Membership Refund Fee Carmel,IN 46032 Expires: Jul 15, 2016 Primary phone: (317)538- 15 Passes Sold 9441 Pass # 130002320: Lee Coolidge Email: Icooli@yahoo.com Pass # 130044744: Campbell Coolidge ID:4491 Pass # 130034753: Clayton Coolidge Pass # 130046029: Cooper Coolidge Pass # 000023641: Becky Coolidge Thanks for your purchase! This pass will automatically renew each month, until cancellation request is received. Cancellation request must be received 7 days prior to billing date. Lee Coolidge Escape Pass-Adult Monthly Membership Each 1.00 $8.00 ($8.00) 799 Bennett Ct. Action: Membership Refund Fee Carmel,IN 46032 Expires: Sep 15, 2016 Primary phone:(317)538- Pass # 130002320: Lee Coolidge 9441 Thanks for your purchase!This pass will Email: Icooli@yahoo.com automatically renew each month, until cancellation ID:4491 request is received. Cancellation request must be received 7 days prior to billing date. Lee Coolidge Escape Pass-Adult Monthly Membership Each 1.00 $8.00 ($8.00) 799 Bennett Ct. Action: Membership Refund Fee Carmel,IN 46032 Expires: Oct 15, 2016 Primary phone:(317)538- Pass # 130002320: Lee Coolidge 9441 Thanks for your purchase! This pass will }7tfnc•//annrnA art;va onm/nar�Y+nlnl--A,n D-I--4D,.,---+ -A: 1 /r1A/'1n1•7 Receipt,#2000497.004 Page 2 of 2 Email:Icooli@yahoo.com automatically renew each month, until cancellation ID:4491 request is received. Cancellation request must be received 7 days prior to billing date. Lee Coolidge Escape Pass-Adult Monthly Membership Each 1.00 $8.00 ($8.00) 799 Bennett Ct. Action: Membership Refund Fee Carmel,IN 46032 Expires: Nov 15, 2016 Primary phone:(317)538- Pass# 130002320: Lee Coolidge 9441 Thanks for your purchase!This pass will Email:Icooli@yahoo.com automatically renew each month, until cancellation ID:4491 request is received. Cancellation request must be received 7 days prior to billing date. Lee Coolidge Escape Pass-Adult Monthly Membership Each 1.00 $8.00 ($8.00) 799 Bennett Ct. Action: Membership Refund Fee Carmel,IN 46032 Expires: Dec 15, 2016 Primary phone: (317)538- Pass# 130002320: Lee Coolidge 9441 Thanks for your purchase! This pass will Email:Icooli@yahoo.com automatically renew each month, until cancellation ID:4491 request is received. Cancellation request must be received 7 days prior to billing date. Lee Coolidge Escape Pass-Adult Monthly Membership Each 1.00 $8.00 ($8.00) 799 Bennett Ct. Action: Membership Refund Fee Carmel,IN 46032 Expires: Jan 15, 2017 Primary phone:(317)538- Pass# 130002320: Lee Coolidge 9441 Thanks for your purchase!This pass will Email:Icooli@yahoo.com automatically renew each month, until cancellation ID:4491 request is received. Cancellation request must be received 7 days prior to billing date. Lee Coolidge Escape Pass-Adult Monthly Membership Each 1.00 $8.00 ($8.00) 799 Bennett Ct. Action: Membership Refund Fee Carmel,IN 46032 Expires: Feb 15, 2017 Primary phone: (317)538- Pass # 130002320: Lee Coolidge 9441 Thanks for your purchase!This pass will Email:Icooli@yahoo.com automatically renew each month, until cancellation ID:4491 request is received. Cancellation request must be received 7 days prior to billing date. - Total Charges ($88.00) Total Payments ($88.00) Balance $0 Federal Tax ID # 35-6000972 u rr✓. �U� 2• � 3 ��rZ L.4+..n•//n..«..nr1 nn�ia a new./nn..,�olnlna,.,nrl.n/nor. lo+/.�r(.nnnnl?nnoira4Dnvrr+nn4nrli 1 /)A/71)1'7