182450 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 363893 Page 1 of 1
ONE CIVIC SQUARE BRIAN MAYES
CARMEL, INDIANA 46032 1182 GCLFVIEW DR, APT #E CHECK AMOUNT: $45.00
CARMEL IN 46032
CHECK NUMBER: 182450
CHECK DATE: 2/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 383571 45.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 383571
Payment Date: 02/02/10
Household 7621
Monon Center Brian Mayes Hm Ph: (866)582 -0804
Carmel IN 46032 1182 Golfview Dr. Apt. E
Carmel IN 46032 Cell Ph:
kmayes @indy.rr.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 45.00
Enrollee Name: Elizabeth Mayes Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 306492 -01 Breakin' 101 0.00 0.00 0.00 9.00 0.00
Enrollment Date: 01/02/2010 (Cancelled)
Primary Instructor. Tumble Time
Class Location: Fitness Studio B Class Dates: 02/02/2010 to 02/23/2010
Monon Center 6:00P to 6:45P
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: low enrollment
GIL Code Description__ Account Numbe CstCnlr De scrip tion Account Nu Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 45.00 DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 02102110 09:07:59 by LVA FEES CHANGED ON CANCELLED ITEMS 45.00
L:
1 3 9 I N ITT NET AMOUNT FROM CANCELLED ITEMS 45.00-
0 E� i 1ij `0 i TOTAL AMOUNT REFUNDED 45.00
F 6�
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 45.00 Made By REFUND FINAN With Reference low enrollment
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
t i c)
Authorized Sig ure Date Aut prized Signature Date
Icc -(4�. L13<;
Lo w C vi r o r lati,_yy
Page 1
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.
Mayes, Brian Terms
1182 Golfview Dr., Apt. Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/2110 383571 Refund 45.0Q
Total I 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
Voucher No. Warrant No.
Mayes, Brian Allowed 20
1182 Golfview Dr., Apt. E
Carmel, IN 46032
In Sum of
45.00
.ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE N0. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -42 383571 4358400 45.00 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
11 -Feb 2010
Signature
45.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund