187231 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 364298 Page 1 of 1
ONE CIVIC SQUARE MARAT BLEYKHMAN
CHECK AMOUNT: $55.00
CARMEL, INDIANA 46032 1433 SEDONA DR
CARMEL IN 46032 CHECK NUMBER: 187231
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 446731 55.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 446731
Payment Date: 06/18/10
Household 27190
Monon Community Center W
0 Marat Bleykhman Hm Ph: (317)566 -8999
Carmel IN 46032 JUN 2 1433 Sedona Dr Wk Ph: (317)529 -8362
carmel IN 46032 Cell Ph:
marat_bleykhman @yahoo.com
Phone: (317)848 -7275 BY:
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 55.00
Enrollee Name: N ickolas Bleykhman f=ees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 103008 -15 Learn to Swim Lvl 3 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 0510412010 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Indoor Lap Pool 4 Class Dates: 06/21/2010 to 06130/2010
Monon Community Cntr 7:05P to 8:OOP
M,W
Carmel IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: advance notice given
GIL Code Description Account Number Cst Cntr Description Account Number _Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 55.00 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 06/18/10 15:59:07 by CEK FEES CHANGED ON CANCELLED ITEMS 55.00-
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 55.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 55.00 Made By REFUND FINAN With Reference advance notice
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.
le ho
Authorized Signature Dale Authorized Signature Date
IQ9
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.
Bleykhman, Marat Terms
1433 Sedona. Dr Date Due
Carmel, I N 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6118110 446731 Refund 55.00
Total 55.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Bleykhman, Marat Allowed 20
1433 Sedona Dr
Carmel, IN 46032
In Sum of
55.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
10916 -10 446731 4358400 55.00 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
1 -Jul 2010
Signature
55.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund