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327100 07/03/18
`���,qy�. CITY OF CARMEL, INDIANA VENDOR: 371758 J` -.: CHECK AMOUNT: $********13.00* .I: ONE CIVIC SQUARE CORTNEY STEWART CARMEL, INDIANA 46032 208 VALI COURT CHECK NUMBER: 327100 v �ruN�:r' INDIANAPOLIS IN 46280 CHECK DATE: 07/03/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 2000829004 13.00 REFUNDS AWARDS & INDE ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by VendorAllowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Stewart, Cortney Payee {\� 208 Vali Court Indianapolis, IN 46280 In Sum of$ Purchase Order# Stewart, COrtney Terms $ 13.00 208 Vali Court Date Due Indianapolis, IN 46280 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO#or nvolce Invoice Description Dept# INVOICE NO. ACCT#/TITLE AMOUNT Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1092 2000829004 4358400 $ 13.00 Board Members 6/20/18 2000829004 Refund $ 13.00 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 $ 13.00 Total $ 13.00 June 28,2018 / I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance /) v with IC 5-11-10-1.6• Cost distribution ledger classification if 'fp�JA/�I claim paid motor vehicle highway fund Signature ..20_ Accounts Payable Coordinator Clerk-Treasurer Title Receipt#2000829.004 Page 1 of 1 Monon Community Center West Building a s , ggmg�202©r] 3P 27 P 1195 Central Park Dr. West Carmel, IN 46032 Phone: (317) 848-7275 FAX: -- Caf I * Cay Email: info@carmelclayparks.com varks&Recreation NATIONAL GOLD MEDAL WINNER CORTN�EY-STEWA�RT 208UALIC*©rIJR•T ::� AND ACCREDITED AGENCY IiN DILA��AP�®LI'N�4627ff� Prepared By: mattw Customer ID: 3919 Primary phone: (317) 610-7170, Secondary phone: -- Refund Summary Check: ($13.00) Check # Total Received: ($13.00) Tiota_I Refuinjft�3,,MQp Transactions Customer Description Item Unit Qty Fee Charge Darion Watson Youth Monthly Pass Membership Each 1.00 $26.00 ($26.00) 208 Vali Court Action: Membership Cancel Fee Indianapolis,IN 46280 Expires:Jun 8, 2018 Primary phone:(317)610- Pass# 130026731: Darion Watson Scholarship Each 1.00 $13.00 $13.00 7170 Thanks for your purchase!This pass will (b) 50% Email:ccollinsl@iuhealth.org automatically renew each month, until cancellation ID:3920 request is received. Cancellation request must be received 7 days prior to billing date. Total Charges ($13.00) �?L Total Payments ($13.00) i Ig. Balance $0 MJ 2 202 th Federal Tax ID # 35-6000972 wrr . ...._......=,...a ..... t odajt3s Foo https:Hanprod.active.com/carmelclayparks/servlet/processReceiptPayment.sdi 6/20/2018