HomeMy WebLinkAbout188108 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364447 Page 1 of 1
ONE CIVIC SQUARE ADAIR WASHINGTON CHECK AMOUNT: $100.00
CARMEL, INDIANA 46032 13647 STONE HAVEN DR
CARMEL IN 46033
CHECK NUMBER: 188108
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 466405 100.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 466405
Payment Date: 07/07/10
Household 35060
t
Monon Community Center Adair Washington Hm Ph: (317)575 -9560
Carmel IN 46032 13647 StoneHaven Dr.
Carmel IN 46033 Cell Ph:
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
'Enrollment Details
CANCELLATION Refund Of 99.00
Enrollee Name: Lea Washington Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476009 -11 Skyhawks Sports 0.00 0.0 0.00 0.00 0.00
Enrollment Date: 06/17/2010 (Cancelled)
Class Location: Skate Park Class Dates: 06/21/2010 to 06/25/2010
Monon Community Cntr 11:30A to 1:30P
M,Tu,W,Th,F
Carmel IN 46032 Scheduled Sessions: 5
(317)848 -7275
Cancel Reason: did not attend camp due to weather and change in instructors
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 1.00
Processed on 07/07/10 14:27:24 by BJJ FEES CHANGED ON CANCELLED ITEMS 99.00-
NET AMOUNT FROM CANCELLED ITEMS 99.00
HH BALANCE APPLIED TO THIS RECEIPT 1.00
TOTAL AMOUNT REFUNDED 100.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 100.00 Made By REFUND FINAN With Reference
r_
All refun s 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.
�uthoriz ignature Date Authorized Signature Date
JUL i 2 2a 0 bu
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 Y Purchase Order No.
Terms
Washington, Adair
Date Due
13647 Stone Haven Dr
Carmel, IN 46033
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
100.00
717/10 466405 Refund
Total 100.00
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
20
Clerk- Treasurer
Voucher No. Warrant No.
Washington, Adair Allowed 20
13647 Stone Haven Dr
Carmel, IN 46033
In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1082 -98 466405 4358400 100.00 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
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund