187097 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: T359911 Page 1 of 1
ONE CIVIC SQUARE MICHAEL WILLIAMS
i 0 CHECK AMOUNT: $73.00
CARMEL, INDIANA 46032 619 BURR OAK DR
.a, CARMEL IN 46032 CHECK NUMBER: 187097
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 430991 73.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 430991
Payment Date: 06/01/10
Household 4053
Monon Center Michael Williams Hm Ph: (317)566 -8912
Carmel IN 46032 619 Burr Oak Drive Wk Ph: (317)237 -2503
Carmel IN 46032 Cell Ph:
aewdad(Rhotmail.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 38.00
Enrollee Name: Lillian Williams Fees +Tax Discount Prev Paid Cur Paid Amount Due
Activity Number. 106329 -01 Rock Solid Boot Camp 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 05/13/2010 (Cancelled)
Primary Instructor Tumble Time
Class Location: Gymnasium B Class Dates: 06/05/2010 to 07/17/2010
Monon Center 11:15A to 12: OOP
Sa
Carmel IN 46032 Scheduled Sessions: 6
(317)848 -7275
Skip Days 07/03/2010
Cancel Reason: low enrollment
CANCELLATION Refund Of 35.00
Enrollee Name: Lillian Williams Fees +Tax Discount Prev Paid Cur Paid Amount Due,
Activity Number. 106370 02 Zoomba Kids 0.00 0.00 0.00 0.00 0.00
Enrollment Date. 05/13/2010 (Cancelled)
Primary Instructor: Tumble Time
Class Location: Dance Studio B Class Dates: 06/03/2010 to 06/24/2010
Monon Center 3:45P to 4:30P
Th
Carmel IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: low enrollment
G/L Code Description Account Number Gst Cntr.. Description_ Account Number Amount
999999 Control Account (AP) Enter Control Acc! CNTRL Control Account (AP) Enter Control Acct here 73.00 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 06/01 /10 15:22:12 by LVA FEES CHANGED ON CANCELLED ITEMS 73.00-
J rr�� NET AMOUNT FROM CANCELLED ITEMS 73.00.
U U N )U I U TOTAL AMOUNT REFUNDED 73.00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 430991
Payment Date: 06/01/2010
Household 4053
Refund of 73.00 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. o cash or credit and refunds. I
la t
Authorized Signat Date Authoriiied Signature Date
X00
Page 2
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.
Williams, Michael Terms
619 Burr Oak Drive Date Due
Carmel, IN 46032
Description
Invoice Invoice
or note attached invoice(s) or bill(s)) Amount
Date Number
73.00
611110 430991 Refund
Total 73.00
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.
Williams, Michael Allowed 20
619 Burr Oak Drive
Carmel, IN 46032
In Sum of
73.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1 096 -4 2 430991 4358400 73.00 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
17 -Jun 2010
Signature
73.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund