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187799 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364420 Page 1 of 1 ONE CIVIC SQUARE AMANDA FININ CHECK AMOUNT: $15.00 CARMEL, INDIANA 46032 1101 HIGH CT CARMEL IN 46033 CHECK NUMBER: 187799 CHECK DATE: 7/21/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 466982 15.00 REFUNDS AWARDS INDE AL, I lV1 I T KLO-U U RECEIPT Receipt 466982 Payment Date: 07/08/10 Household 35673 Monon Community Center Amanda Finin Hm Ph: 317 84 Carmel IN 46032 1101 High CT 3 -0592 Carmel IN 46033 Cell Ph: Phone: (317 )848 -7275 marfinin@gmail.com Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION -Refund Of 15.00 Enrollee Name: Amanda Finin Fees +Tax Disca�nt Prev Paid d Paid Due Amount Due Activity Number. 104710 -03 Healthy Back o 00 0.00 0.00 D Enrollment Date: 06/12/2010 (Cancelled) Class Location: Fitness Studio B Class Dates: 07/09/2010 to 07109/2010 Monon Community Cntr 1:OOP to 2:OOP F Carmel, IN 46032 Scheduled sessions: 1 (317)848 -7275 Cancel Reason: low enrollment PREVIOUS NET "OUSEHOLD BALANCE 0.00 Processed on 07/08/10 07:33:59 by CNA FEES CHANGED ON CANCELLED ITEMS 15.00 NET AMOUNT FROM CANCELLED ITEMS 15.00 7 TOTAL AMOUNT REFUNDED 15.00 NEW NET HOUSEHOLD BALANCE 000 Refund of =n 15.00 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 issued. No cash or credit card refunds. �Wjlj�tcu q 10 Authorized Signature Date 6 Date in; JUL 14 X010 0 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. Finin, Amanda Terms 1101 High Ct Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 718110 466982 Refund 15.00 Total 15.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 1 20 Clerk Treasurer Voucher No. Warrant No. Finin, Amanda Allowed 20 1101 High Ct Carmel, IN 46033 In Sum of 15.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1096 -22 466982 4358400 15.00 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 15 -Jul 2010 Signature 15.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund