312929 6/26/2017-VOIDED 4+W C.1MMf!
CITY OF CARMEL, INDIANA VENDOR: 371742 CHECK AMOUNT: S"'"""'"'45.00'
JENNIFER BUTTERWORTH
ONE CIVIC SQUARE 3sz aovLsroN sr aazz CHECK NUMBER: 312929
,' =Q CARMEL, INDIANA 46032 CARMEL IN 46032 CHECK DATE: 06/26/17
DESCRIPTION
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT REFUNDS AWARDS & INDE
1096 4358400 2002071003 45.00
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.
Butterworth, Jennifer Terms
362 Boylston Street#422 Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/19/17 2002071003 Refund $ 45.00
Total $ 45.00
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
t
6/19/2017 Receipt#2002071.003
Monon Community Center East Building Voucher #2002071.003
1235 Central Park Dr. East Jun 19, 2017 5:11 PM
Carmel, IN 46032
Phone: (317) 848-7275
FAX: -- Car el *
Email: info@carmelclayparks.com
PaFks&ReCFeation
JENNIFER BUTTERWORTH NATIONAL GOLD MEDAL WINNER
362 BOYLSTON STREET #422 AND ACCREDITED AGENCY
CARMEL, IN 46032
c
JUN 2017 Prepared By: michelley
Customer ID: 52961
BY:.......................P.rimry phone: (317) 574-1855, Secondary phone: --
Refund Surnmar•y
Check: ($45.00) Check #
Total Received: ($45.00) Total Refund: ($45.00)
Transactions
Customer Description Item Unit Qty Fee Charge
Kyle Butterworth Adaptive Adult Water Walking #178039-02 Activity Fee Each 1.00 $25.00 ($25.00)
362 Boylston Street#422 Action:Withdraw
Carmel,IN 46032 Withdrawal Date:Jun 19,2017
Primary phone: (317) 574-1855
Email: buttersgirl78@aol.com Meets: From July 5,2017 to July 26,2017
ID: 207 Each Wednesday from 10am to 10:45am
Location: Lazy River at Monon Community Center Waterpark
Kyle Butterworth Adaptive Adult Water Walking #178039-01 Activity Fee Each 1.00 $20.00 ($20.00)
362 Boylston Street#422 Action:Withdraw
Carmel,IN 46032 Withdrawal Date:Jun 19,2017
Primary phone: (317) 574-1855
Email: buttersgir178@aol.com Meets: From June 7,2017 to June 28,2017
ID: 207 Each Wednesday from loam to 10:45am
Location: Lazy River at Monon Community Center Waterpark
Total Charges ($45.00)
Total Payments ($45.00)
Balance $0
7
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