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313662 7/18/2017
(9) CITY OF CARMEL, INDIANA VENDOR: 371799 ONE CIVIC SQUARE AMY CHARLES CHECK AMOUNT: S********63.00* CARMEL, INDIANA 46032 10876 QUEENSBURY CT CHECK NUMBER: 313662 CARMEL IN 46033 CHECK DATE: 07/18/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 2000687006 63.00 REFUNDS AWARDS & INDE $ 0 0 � § $ m2 O / w aR 2 > P o / C \ o / - / & 6 B © 2 \ 0) E co m C n CD z ko g k> &0 T w0 CA 7 = ECD k § / q @ J ƒ m ;u CDE A \_ © � �_ P . . 2 6 2 w % \ 0 m S R R — D § \ 2 = £ E CD 0 / F § k » / C Q � 0) > -0 CD— m 3 ) cn C e ƒ (D \ @ — 2 7 & » k w % \ § k 2 i3 m o 2 0 o E a & m � \ � k \ F. 0 CL B 9 ` ^ ° §� _ K $ $ o � § | \ a Administrative Offices Voucher #2000687.006 1411 E. 116th Street i ,x�.. '�, Jul 4, 20179:51AM Carmel, IN 46032 ; Phone: (317) 848-7275 FAX: -- p � lay Email: info@carmelclayparks.com I ar C Parks&Recreation AMY CHARLES NATIONAL GOLD MEDAL WINNER 10876 QUEENSBURY COURT CARMEL, IN 46033 AND ACCREDITED AGENCY Prepared By: jordanh Customer ID: 53358 Primary phone: (317) 829-4444, Secondary phone: (317) 829-4155 Check: ($63.00) Check # Total Received: ($63.00) Total Refund: ($63.00) custo"Iet Description ?a=lts Unit Qty Fee Charge Eric Charles Crouching Tiger Cubs#175001-02 Activity Fee Each 1.00 $63.00 ($63.00) 10876 Queensbury Court Action;:Withdraw Carmel,IN 46033 Withdrawal Date: Jul 4, 2017 Primary phone:(317)829- 4444 Meets: From July 5, 2017 to July 26, 2017 Email: -- Each Wednesday from 9:30am to 10am ID:53360 Location: Multipurpose Room East C at Monon Community Center East Building Total Charges ($63.00) Total Payments ($63.00) Balance $0 f0`1(0 Lf 3y p100 7/6/7