HomeMy WebLinkAbout188054 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: T362191 Page 1 of 1
ONE CIVIC SQUARE MICHELLE SHADRICK
CARMEL, INDIANA 46032 3621 EDEN PLACE CHECK AMOUNT: $218.00
CARMEL IN 46033
CHECK NUMBER: 188054
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 459545 218.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 459545
Payment Date: 07/01/10
Household 8375
Monon Community Center Michelle Shadrick Hrn Ph: (317)581 -9698
Carmel IN 46032 3621 Eden Place
Carmel IN 46033 Cell Ph:
mshadrick @indy.rr.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 218.00
Enrollee Name: Shelby Shadrick Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 303023 -01 Lifeguard Course 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 01121/2010 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Party Room B Class Dates: 01/23/2010 to 01/31/2010
Monon Community Cntr 9:OOA to 6:OOP
Su,Sa
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: Not able to perform pre requisite skills
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07101/10 15:31:58 by CEK FEES CHANGED ON CANCELLED ITEMS 225.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00-
NET`AMOUNT�FROM °CANCEL'LED ITEMS .218100 =;1>
TOTAL�AMOUNTREF.UNDED.
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 218.00 Made By REFUND FINAN With Reference refund
Rewards Points refunded on this receipt: 0.70 t 9 C�
Household Reward Point Balance: 47.70 J U I U 20
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. ,/33fteck wi ll be
issued. No cash or credit card refunds.
Authorized Signature Date Authorized Signature Date
1 0 1 la 1D.
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.
Terms
Shadrick, Michelle
Date Due
3621 Eden Place
Carmel, IN 46033
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
218.00
711110 459545 Refund
Total 9 218.00
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
20
Clerk- Treasurer
Voucher No. Warrant No.
Shadrick, Michelle Allowed 20
3621 Eden Place
Carmel, IN 46033
In Sum of
218.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -10 459545 4358400 218.00 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
218.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund