HomeMy WebLinkAbout188064 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364442 Page 1 of 1
0 ONE CIVIC SQUARE CLAY SPRINGER CHECK AMOUNT: $160.00
CARMEL, INDIANA 46032 13400 ALSTON DR
FISHERS IN 46037
zo CHECK NUMBER: 188064
CHECK DATE: 7121/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 458963 160.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 458963
Payment Date: 07/01/
16677
Household 16677
JUL 0 2010 U
Monon Community Center ��e Clay Springer Hm Ph: (317)509 -3323
Carmel IN 46032 13400 Alston Drive
fishers IN 46037 Cell Ph:
beth.grassykncll@gmail.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 80.00
Enrollee Name: Austin Springer Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -16 Vacation Station 80.00 0.00 80.00 0.00 0.00
Enrollment Date: 02/22/2010 (Cancelled)
Class Location: Clay Middle School Class Dates: 07/05/2010 to 07/09/2010
Clay Middle School 7:OOA to 6:OOP
5150 East 126th Street M,Tu,W,Th,F
Carmel IN 46033 Scheduled Sessions: 5
(317)848 -7275
Cancel Reason: un a blle to attend mother wants to cancel
CANCELLATION Refund Of 80.00
Enrollee Name: Ashley Springer Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -16 Vacation Station 80.00 0.00 80.00 0.00 0.00
Enrollment Date: 02/22/2010 (Cancelled)
Class Location: Clay Middle School Class Dates: 07/05/2010 to 07/09/2010
Clay Middle School 7:OOA to 6:OOP
5150 East 126th Street M,Tu,W,Th,F
Carmel, IN 46033 Scheduled Sessions: 5
(317)848 -7275
Cancel Reason: unablle to attend, mother wants to cancel
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/01/10 11:31:02 by LAA FEES CHANGED ON CANCELLED ITEMS 160.00
NET AMOUNT FROM CANCELLED ITEMS 160.00
TOTAL AMOUNT REFUNDED 160.00 v
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 160.00 Made By REFUND FI NAN With Reference
All refunds ar subj
o' sh or ect to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
Issued. N credit card refunds.
Auth n AdSignature Date Authorized Signature Date
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
Springer, Clay Purchase Order No.
13400 Alston Drive Terms
Fishers, IN 46037 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s))
7/1/10 458963 Refund Amount
160.00
1 hereby certify that the attached invoice(s), or biil(s) is (are) true and correct and i have audited same in accordance
160.00
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
Springer, Clay Allowed 20
13400 Alston Drive
Fishers, IN 46037
In Sum of
160.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -1 458963 4358400 160.00 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
160.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund