187371 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 364314 Page 1 of 1
ONE CIVIC SQUARE SHAWN MACE
CARMEL, INDIANA 46032 353 TERRENTS CT CHECK AMOUNT: $40.00
CARMEL IN 46032
CHECK NUMBER: 187371
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOU DESCRIPTION
1096 4358400 456947 40.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 456947
Payment Date: 06/29/10
Household 1916
Monon Community Center Shawn Mace Hm Ph: (317)844 -7893
Carmel IN 46032 353 Terrents Ct. Wk Ph: (317)727 -8953
Carmel IN 46032 Cell Ph:
smaceO930@aol.com
Phone: (317)848-7275
Fea Tax ID #35- 6000972
Enrollment Details
CANCELLATION Ref ind Of 40.00
Enrollee Name: Shawn Mace Fees +Tax Disoount Prev Paid Cur Paid Amount Due
Activity Number. 109002 -01 Family Campout 0.00 aco 0.00 0.00 0.00
Enrollment Date: 05/2412010 (Cancelled)
Primary Instructor. CCPR Staff
Class Location: West Park Field Class Dates 06/11/2010 to 06/12/2010
West Park 4:30P to 9:OOA
2700 W. 116th St. F,Sa
Carmel, IN 46032 Scheduled Sessions: 2
(317)848 -7275
Cancel Reason- advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/29110 05 -1530 by CNA FEES CHANGED ON CANCELLED ITEMS 40.00
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT REFUNDED 40.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 40.00 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. No rash or credit card refunds.
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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,
Mace, Shawn Terms
353 Terrents Ct Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6129110 456947 Refund 40.00
Total 40.00
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.
Mace, Shawn Allowed 20
353 Terrents Ct
Carmel, IN 46032
In Sum of
40.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1096 -60 456947 4358400 40.00 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
40.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund