187971 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364430 Page 1 of 1
ONE CIVIC SQUARE ELIZABETH NICE
0 CHECK AMOUNT: $200.00
CARMEL, INDIANA 46032 747 GREENFORD TR
CARMEL IN 46032 CHECK NUMBER: 187971
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 459863 200.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 459863
Payment Date: 07/02/10
Household 13949
Monon Community Center Elizabeth Nice Hm Ph: (317)669 -2928
Carmel IN 46032 747 Greenford Tr
Carmel IN 46032 Cell Ph:
nicefamily5 @sbcglobal.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 200.00
Enrollee Name: Janet Nice Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 103023 -01 Lifeguard Class 0.00 0.0o 0.00 0.00 0.00
Enrollment Date: 05/08/2010 (Cancelled)
Class Location: Party Room B Class Dates: 06/08/2010 to 06/11/2010
Monon Community Cntr 8:30A to 5:30P
Tu,W,Th,F
Carmel IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: Advance request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/02/10 10:47:05 by ERM FEES CHANGED ON CANCELLED ITEMS 200.00
NET AMOUNUFROMpCANCELLEDIVEMS Z 20007
TtOTALIAMOUNT�REFUNDEDi:. iA N
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 200.00 Made By REFUND FINAN With Reference Advance 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 cash or credit card refunds.
G
Authorized Signature to Authorized Signature Date
J UL d. 2010
Y
B Y
Page 1
ACCOUNTS PAYABLE VOUCHER
r. 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.
Nice, Elizabeth Terms
747 Greenford Tr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/2110 459863 Refund 200.00
Total 200.00
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.
Nice, Elizabeth Allowed 20
747 Greenford Tr
r Carmel, IN 46032
In Sum of
200.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #rTITLE AMOUNT Board Members
Dept
1096 -10 459863 4358400 200.00 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
200.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund