187310 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 364308 Page 1 of 1
Q� ONE CIVIC SQUARE MICHAEL GUZMAN
CARMEL, INDIANA 46032 1030 BARD LANE CHECK AMOUNT: $5.80
CARMEL IN 46032 CHECK NUMBER: 187310
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 457524 5.00 REFUNDS AWARDS TNDE
ACTIVITY REFUND RECEIPT
Receipt 457524
Payment Date: 06129110
Household 13799
Monon Community Center Michael Guzman Hm Ph: (317)
Carmel IN 46032 1030 Bard Lane Wk Ph: (317)416 -4006
Carmel IN 46032 Cell Ph:
mguzffian8O7O@sbeglobal.net
Phone: (317)848 -7275
Fed Tax tD #35- 6000972
Enrollment Details
CANCELLATION;- Refund Of 5.00
Enrollee Name: Michael Guzman Fees +Tax Disooul t Prey Paid Cur Paid Amount Due
Activity Number 109049 -01 Community Garage Sal 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 0512012010 (Cancelled)
Class Location: Parking Lot East Class Dates: 05/22/2010 to 05/22/2010
Monon Community Cntr 10:OOA to 4:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: no space available
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/29/10 15:15:17 by CNA FEES CHANGED ON CANCELLED ITEMS 5.00
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT REFUNDED 5.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 5.00 Made By REFUND FINAN With Reference no space
All refunds are subject to State Board of Amounts claim procure and may take 4-6 weeks to process. A check will be
issued. No cash or credit card refunds.
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Autilorized Signature Date Auftdzed Signatum D to
JUL 4 .2 2010
BY
10 9U. UO. q35W)0 no space 0-v
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.
Guzman, Michael Terms
1030 Bartd Lane Date Due
Carmel, I N 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6129110 457524 Refund 5.00
Total 5.00
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.
Guzman, Michael Allowed 20
1030 Bartd Lane
Carmel, IN 46032
In Sum of
5.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -60 457524 4358400 5.00 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
2 -Jul 2010
Signature
5.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund