187397 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 364320 Page 1 of 1
ONE CIVIC SQUARE CHARLES OLT
0 CHECK AMOUNT: $34.00
CARMEL, INDIANA 46032 12543 SPRING VIOLET PLACE
CARMEL IN 46033 CHECK NUMBER: 187397
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 457465 34.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 457465
Payment Date: 06/29/10
Household 18424
lonon Community Center Charies Olt Hm Ph: (317)844 -6104
armel IN 46032 12543 Spring Violet PI Wk Ph: (317)
Carmel IN 46033 Cell Ph:
dorisolt @sbcglobal.net
hone: (317)848 -7275
ed ""ax ID #35- 6000972
brollment Details
CANCELLATION Refund Of 34.00
Enrollee Name: Andrew Olt Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 108123 -01 SANDsational 0.00 0.00 0.00 a.0o 0.00
Enrollment Date: 04/23/2010 (Cancelled)
Class Location: Outdoor Aqua Sand PI Class Dates: 07/05/2010 to 07/26/2010
Monon Community Cntr 10:OOA to 11:OOA
M
Carmel IN 46032 Scheduled Sessions: 4
(317)848 7275
Cancel Reason: Low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/29/10 14:48:34 by BNT FEES CHANGED ON CANCELLED ITEMS 34.00
NET'AMOUNT FROM CANCELLED ITEMS 34.00
TOTAL AMOUNT REFUNDED "34.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 34.00 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
ssued No cash or redit card refunds.
Authorized Sig a re Date Auth ized Signature Date
JUL 022010
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.
Olt, Charles Terms
12543 Spring Violet PI Date Due
Carmel, In 46033
a
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
34.00
6129110 457465 Refund
Total 34.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with L 5- 11- 10 -1.6
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Olt, Charles Allowed 20
12543 Spring Violet PI
Carmel, In 46033
In Sum of
34.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -70 457465 4358400 34.00 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
34.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund