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Home My WebLink About186862 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 364259 Page 1 of 1 ONE CIVIC SQUARE JEFF HUDSON CARMEL, INDIANA 46032 11125 SAINT CHARLES PLACE CHECK AMOUNT: $1,120.00 Lech `o CARMEL IN 46033 CHECK NUMBER: 186862 CHECK DATE: 6/23/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1082 4358400 433134 1,120.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT Receipt 433134 Payment Date: 06/04/10 Household 20979 Mohawk Trails Elemen Jeff Hudson Hm Ph: (317)569 -0188 4242 East 126th Street 11125 Saint Charles Place Carmel IN 46033 Carmel IN 46033 Ext. 32 jeff @laynehudson.com; hudsonks @lilly.cOnil Ph:(317)250 -7096 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 160.00 Enrollee Name: Elayna Hudson Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476002 -02 Preschool Palace 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/1112010 (Cancelled) Class Location: Orchard Park Elem Class Dates: 06/07/2010 to 06/11/2010 Orchard Park Element 8:30A to 5:30P 10404 Orchard Park Drive South M,Tu,W,Th,F Indianapolis, IN 46280 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: child not potty trained CANCELLATION Refund Of 160.00 Enrollee Name: Elayna Hudson Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476002 -03 Preschool Palace 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01111/2010 (Cancelled) Class Location: Orchard Park Elem Class Dates: 06/14/2010 to 06/18/2010 Orchard Park Element 8:30A to 5:30P 10404 Orchard Park Drive South M,Tu,W,Th,F Indianapolis, IN 46280 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: child not potty trained CANCELLATION Refund Of 160.00 Enrollee Name: Elayna Hudson Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476002 -04 Preschool Palace 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/11/2010 (Cancelled) Class Location: Orchard Park Elem Class Dates: 06/21/2010 to 06/25/2010 Orchard Park Element 8:30A to 5:30P 10404 Orchard Park Drive South M,Tu,W,Th,F Indianapolis, IN 46280 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: child not potty trained CANCELLATION Refund Of 160.00 Enrollee Name: Elayna Hudson Fees Tax Discount. Prev Paid Cur Paid Amount Due Activity Number: 476002 -05 Preschool Palace 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01111/2010 (Cancelled) n Page 1 ACTIVITY REFUND RECEIPT Receipt 433134 Payment Date: 06/04/2010 Household 20979 Class Location: Orchard Park Elem Class Dates: 06128(2010 to 07/02/2010 Orchard Park Element 8:30A to 5:30P 10404 Orchard Park Drive South M,Tu,W,Th,F Indianapolis, IN 46280 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: child not potty trained CANCELLATION Refund Of 160.00 Enrollee Name: Elayna Hudson Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476002 -07 Preschool Palace 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/11/2010 (Cancelled) Class Location: Orchard Park Elem Class Dates: 0 711 2120 1 0 to 07/16/2010 Orchard Park Element 8:30A to 5:30P 10404 Orchard Park Drive South M,Tu,W,Th,F Indianapolis, IN 46280 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: child not potty trained CANCELLATION Refund Of 160.00 Enrollee Name: Elayna Hudson Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476002 -08 Preschool Palace 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/11/2010 (Cancelled) Class Location: Orchard Park Elem Class Dates: 07/19/2010 to 07/23/2010 Orchard Park Element 8:30A to 5:30P 10404 Orchard Park Drive South M,Tu,W,Th,F Indianapolis, IN 46280 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: child not potty trained CANCELLATION Refund Of 160.00 Enrollee Name: Elayna Hudson Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number. 476002 -09 Preschool Palace 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/11/2010 (Cancelled) Class Location: Orchard Park Elem Class Dates: 07/26/2010 to 07/30/2010 Orchard Park Element 8:30A to 5:30P 10404 Orchard Park Drive South M,Tu,W,Th,F Indianapolis, IN 46280 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: child not potty trained iGIL Code Description Accou Number C st Cntr Description Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 1120.00 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. Page 2 ACTIVITY REFUND RECEIPT Receipt# 433134 Payment Date: 06/0412010 Household 20979 PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 06/04/10 13:28:09 by CMC FEES CHANGED ON CANCELLED ITEMS 1,120.00- NET;AMOUNT F,R0WCANCELLEDm= ITEMS~ TOTA6,AMOUNT`IREFUNDED a1 120:00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 1,120.00 Made By R EFUND FINAN With Reference All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A chec will be issued. iV cash or credit card refunds. t>vo6ignature Date Authorized Signature Date JUN 0 7 1010 13Y p n Page 3 1t1� 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. Hudson, Jeff Terms 11125 Saint Charles Place Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 614110 433134 Refund 1,120.00 Total 1,120.00 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, Hudson, Jeff Allowed 20 11125 Saint Charles Place Carmel, IN 46033 In Sum of 1,120.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT 4MTLE AMOUNT Board Members Dept 1082 -2 433134 4358400 1,120.00 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 i 17 -Jun 2010 Signature 1,120.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund