HomeMy WebLinkAbout187421 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 364322 Page 1 of 1
ONE CIVIC SQUARE BETH QUIGLEY
CARMEL, INDIANA 46032 5774 MEADOWLARK PLACE CHECK AMOUNT: $150.00
CARMEL IN 46033 CHECK NUMBER: 187421
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 456534 150.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 456534
Payment Date: 06/28/10
Household 25303
Monon Community Center Beth Quigley Hm Ph: (317)581 -8962
Carmel IN 46032 5774 Meadowlark Place
Carmel IN 46033 Cell Ph:
Whone: (317)848 -7275 mbajquig @aol.com
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 150.00
Enrollee Name: Jack Quigley Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 106480 -01 Offensive Skills Cli 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/1812010 (Cancelled)
Primary Instructor: DeFUSCio ,lay
Class Location: Gymnasium C Class Dates: 07/19/2010 to 07/22/2010
Monon Community Cntr 9:OOA to 12-OOP
M,Tu,W,Th
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: pacers cancelled- advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/28/10 14:53:00 by LVA FEES CHANGED ON CANCELLED ITEMS W 150.00
NET AMOUNT FROM CANCELLED ITEMS 154.00
TOTAL AMOUNT REFUNDED 150.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 150.00 Made By REFUND FINAN With Reference advanced request
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 card refunds.
;N110
Authorized 9tu Date Author ed Signature Date
VAS p k
q q q S--8L1QD Jul 0 201
By........................
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.
Quigley, Beth Terms
5774 Meadowlark Place Date Due
t; Carmel, In 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/28/10 456534 Refund 150.00
Total 150.00
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
s
Voucher No. Warrant No.
Quigley, Beth Allowed 20
5774 Meadowlark Place
Carmel, In 46033
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -42 456534 4358400 150.00 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
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund