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Home My WebLink About188321 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: T361071 Page 1 of 1 ONE CIVIC SQUARE JASON FLEMING i CHECK AMOUNT: $32.50 ,a CARMEL, INDIANA 46032 17474 EASTWICK CIRCLE ory �o CARMEL IN 46033 CHECK NUMBER: 188321 CHECK DATE: 8/312010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4355400 481309 32.50 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT Receipt 481309 Payment Date: 07121/10 Household 10334 Monon Community Center Jason Fleming Hm Ph: (317)818 -8441 Carmel IN 46032 11974 Eastwick Circle Carmel IN 46033 Cell Ph: tchang @siumed.edu -Phone: (317)848-7275 ,Fed Tax ID #35- 6000972 ti Enrollment Details CANCELLATION Enrollee Name: Mia Fleming Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number. 105241 -04 Beautiful Ballerina 32.50 0.00 0.00 32.50 0.00 Enrollment Date: 04/0112010 (Cancelled) Class Location: Dance Studio B Cass Dates: 06/16/2010 to 08/04/2010 Monon Community Cntr 11:OOA to 11:30A W Carmel, IN 46032 scheduled sessions 8 (317)848 -7275 Cancel Reason: prorated refund The following item reflects a payment towards a previous receipt Enrollee Name: Tina Fleming Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 103007 -02 Learn to Swim Lvl 2 55.00 0.00 45.00 10.00 0.00 Enrollment Date, 04/01/2010 (Enrolled) Primary Instructor. CCPR Staff Class Location: Indoor Lap Pool 3 Class Dates: 05104/2010 to 05125/2010 Monon Community Cntr 5:05P to 6:00P Tu Carmel, IN 46032 Scheduled sessions: 4 (317)848 -7275 The following item reflects a payment towards a previous receipt Enrollee Name: Tina Fleming Fees +Tax Discount Prey Paid Cur Paid Amount Due Activity Number 103007 -12 Learn to Swim Lvl 2 55.00 0.00 0.00 22.50 32.50 Enrollment Date: 04/01/2010 (Enrolled) Primary Instructor. CCPR Staff Class Location: Indoor Lap Pool 3 Class Dates: 06/08/2010 to 06/17/2010 Monon Community Cntr 5:05P to 6:OOP Tu,Th Carmel, IN 46032 Scheduled Sessions: 4 (317)848 -7275 Page 1 ACTIVITY REFUND RECEIPT Receipt 481309 Payment Date: 07/21/2010 Household 10334 PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 07/21/10 13:11:33 by CNA FEES CHANGED ON CANCELLED ITEMS 65.00- SURCHARGE APPLIED AGAINST CANCEi FEES 32.50 NET AMOUNT FROM CANCELLED ITEMS 32:50 FEES ADJUSTED ON CHANGED ITEMS 0.00 NET AMOUNT FROM CHANGED ITEMS D.OD TOTAL AMOUNTREFUNDED 32.50,: NEW NET HOUSEHOLD BALANCE 0.00 Refund of 32.50 Made By REFUND FINAN with Reference prorated refund Payment of 32.50 Made By Activity Registration Credit Balance Rewards Points refunded on this receipt: 325 Household Reward Point Balance: 7.75 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. 6��AW 01 7L,2+1 7 7Z Authorized Signature Date AUIWn2Q Signature Date Enjoy your escape at the MCC. JUL 2010 By:- 10 b. '39 .g358 00 -fro foAe& req u&E v P age 2 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. Fleming, Jason Terms 11974 Eastwick Circle Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7121110 481309 Refund 32.50 Total 32.50 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. Fleming, Jason Allowed 20 11974 Eastwick Circle Carmel, IN 46033 In Sum of 32.50 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1096 -32 481309 4358400 32.50 l 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 29 -Jul 2010 Signature 32.50 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund