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315182 8/22/2017 CITY OF CARMEL, INDIANA VENDOR: 370758 CHECK AMOUNT: $*******580.00* ONE CIVIC SQUARE AMBER TITUS =a; CARMEL, INDIANA 46032 324 LEXINGTON BLVD CHECK NUMBER: 315182 ,M CARMEL IN 46032 CHECK DATE: 08/22/17 ��ON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4358400 2000144022 290.00 REFUNDS AWARDS & INDE 1081 4358400 200143022 290.00 REFUNDS AWARDS & INDE 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. Titus, Amber Terms 324 Lexington Blvd Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 8/16/17 2000143022 Refund $ 290.00 8/16/17 2000144022 Refund $ 290.00 Total Is 580.00 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 8/16/2017 Receipt#2000143.022 Carmel Elementary School Voucher #2000143.022 101 4th Avenue SE Aug 16, 2017 6:33 AM Carmel, IN 46032 Phone: (317) 258-8266 FAX: -- � ' . IEmail: info@carmelclayparks.com Car PaFks&ReCFeation AMBER TITUS NATIONAL GOLD MEDAL WINNER 324 LEXINGTON BLVD CARMEL, IN 46032 AND ACCREDITED AGENCY Prepared By: jessicae Customer ID: 19678 Primary phone: (317) 514-0202, Secondary phone: (317) 514-0202 Refund Summary Check: ($290.00) Check # Total Received: ($290.00) Total Refund: ($290.00) Transactions Customer Description Item Unit Qty Fee Charge Parker Titus Carmel Before&Afterschool(Monthly): Aug 1, 2017-Aug ESE Each 1.00 $290.00 ($290.00) 324 Lexington Blvd 31,2017#6002 Enrollment Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Fees Primary phone:(317)514-0202 (Monthly) Email:eileen_vine@hotmail.com ID: 19679 Parker Titus Carmel Before&Afterschool(Monthly): Sep 1, 2017-Sep 324 Lexington Blvd 30, 2017#6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmail.com ID: 19679 Parker Titus Carmel Before&Afterschool(Monthly): Oct 1, 2017-Oct 31, 324 Lexington Blvd 2017 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmaii.com ID: 19679 Parker Titus Carmel Before&Afterschool(Monthly): Nov 1, 2017 -Nov 324 Lexington Blvd 30, 2017 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmail.com ID: 19679 Parker Titus Carmel Before&Afterschool (Monthly): Dec 1, 2017- Dec 324 Lexington Blvd 31, 2017#6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmail.com l �. ID: 19679 — I h C Parker Titus Carmel Before&Afterschool(Monthly): Jan 1, 2018-Jan 31, 324 Lexington Blvd 2018 #6002 Carmel,IN 46032 Action:Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 V Email:eileen_vine@hotmail.com ID: 19679 Parker Titus Carmel Before&Afterschool(Monthly): Feb 1, 2018- Feb 28, 324 Lexington Blvd 2018#6002 Carmel,IN 46032 Action:Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmail.com ID: 19679 Parker Titus Carmel Before&Afterschool(Monthly): Mar 1, 2018- Mar 1u 324 Lexington Blvd 31, 2018#6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund https://anprod.active.com/carmelclayparks/servlet/ShowReceipt.sdi?receiptheader id=589803&originalversion=true&new window=yes 1/2 8/16/2017 Receipt#2000143.022 Primary phone: (317)514-0202 Email:eileen_vine@hotmail.com ID: 19679 Parker Titus Carmel Before&Afterschool(Monthly): Apr 1, 2018 -Apr 30, 324 Lexington Blvd 2018 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmaiLcom ID: 19679 Parker Titus Carmel Before&Afterschool(Monthly): May 1, 2018- May 324 Lexington Blvd 31, 2018 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmaiLcom ID: 19679 Total Charges ($290.00) Total Payments ($290.00) Balance $0 Federal Tax ID # 35-6000972 https://anprod.active.com/carmelclayparks/servlet/ShowReceipt.sdi?receiptheader_id=589803&originalversion=true&new_window=yes 2/2 8/16/2017 Receipt#2000144.022 Carmel Elementary School Voucher #2000144.022 101 4th Avenue SE Aug 16, 2017 6:35 AM Carmel, IN 46032 Phone: (317) 258-8266 FAX: -- el . Clay Email: info@carmelclayparks.com Carm Parks&Recreation AMBER TITUS NATIONAL GOLD MEDAL WINNER 324 LEXINGTON BLVD CARMEL, IN 46032 AND ACCREDITED AGENCY Prepared By: jessicae Customer ID: 19678 Primary phone: (317) 514-0202, Secondary phone: (317) 514-0202 Refund Summary Check: ($290.00) Check # Total Received: ($290.00) Total Refund: ($290.00) transactions Customer Description Item Unit Qty Fee Charge Sofia Titus Carmel Before&Afterschool(Monthly): Aug 1, 2017-Aug ESE Each 1.00 $290.00 ($290.00) 324 Lexington Blvd 31, 2017#6002 Enrollment Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Fees Primary phone: (317)514-0202 (Monthly) Email:eileen—vine@hotmail.com ID:35601 Sofia Titus Carmel Before&Afterschool(Monthly): Sep 1, 2017-Sep 324 Lexington Blvd 30, 2017 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen vine@hotmail.com ID:35601 Sofia Titus Carmel Before&Afterschool(Monthly): Oct 1, 2017 -Oct 31, 324 Lexington Blvd 2017 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmaii.com ID:35601 Sofia Titus Carmel Before&Afterschool(Monthly): Nov 1, 2017-Nov 324 Lexington Blvd 30, 2017#6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen—vine@hotmail.com ID:35601 Titus Carmel Before&Afterschool(Monthly): Dec 1, 2017 Dec 324 L 324 Lexington Blvd 31, 2017#6002 1 — XXUU Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone. (317)514-0202 Email:eileen—vine@hotmail.com ID:35601 Sofia Titus Carmel Before&Afterschool(Monthly): Jan 1, 2018-Jan 31, 324 Lexington Blvd 2018 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen—vine@hotmaii.com ID:35601 Sofia Titus Carmel Before&Afterschool(Monthly): Feb 1, 2018- Feb 28, 324 Lexington Blvd 2018 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen—vine@hotmail.com ID:35601 Sofia Titus Carmel Before&Afterschool(Monthly): Mar 1, 2018- Mar 324 Lexington Blvd 31, 2018 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund https://anprod.active.com/cannelclayparks/servlet/ShowReceipt.sdi?receiptheader_id=589804&originalversion=true&new_window=yes 1/2 8/16/2017 Receipt#2000144.022 Primary phonA: (317)514-0202 Email:eileen_vine@hotmail.com ID:35601 Sofia Titus Carmel Before&Afterschool(Monthly): Apr 1, 2018 -Apr 30, 324 Lexington Blvd 2018 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone: (317)514-0202 Email:eileen_vine@hotmail.com ID:35601 Sofia Titus Carmel Before&Afterschool (Monthly): May 1, 2018- May 324 Lexington Blvd 31, 2018 #6002 Carmel,IN 46032 Action: Extended School Enrichment FlexReg Refund Primary phone:(317)514-0202 Email:eileen_vine@hotmail.com ID: 35601 Total Charges ($290.00) Total Payments ($290.00) Balance $0 Federal Tax ID # 35-6000972 https://anprod.active.com/carmelclayparks/servlet/ShowReceipt.sdi?receiptheader_id=589804&originalversion=true&new_window=yes 2/2