HomeMy WebLinkAbout188339 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 364499 P89@ 1 of 1
ONE CIVIC SQUARE TRACI GOODWIN CHECK AMOUNT: $19.00
s CARMEL, INDIANA 46032 3815 NUTHATCHER OR
INDIANAPOLIS IN 46228 CHECK NUMBER: 188339
CHECK DATE: 8/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 482883 19.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 482883
Payment Date: 07/23/10
Household 35167
Monon Community Center Traci Goodwin Hm Ph: (317)694 -0431
Carmel IN 46032 3815 Nuthatcher Dr,
Indianapolis IN 46228 Cell Ph:
traci.goodwin @gmail.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 19.00
Enrollee Name: Sam Goodwin Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 103001 -15 Parent Child LvI 1 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 05/26/2010 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Ind Leisure 1 Class Dates: 08/03/2010 to 08/24/2010
Monon Community Cntr 6:30P to 7:OOP
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: Advanced Request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/23/10 12:53:27 by ERM FEES CHANGED ON CANCELLED ITEMS 26.00
SURCHARGE APPLIED AGAINST CANCELLED FEES O 7.00
NET- AMOUNTfROM'cANCELLED.ITEMS
TO,TAL C.. a
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 19.00 Made By REFUND FINAN With Reference Advanced 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.
2 O
Authorized Signature Date Authorized Signature Date
W l®' 'f 35 4-1CV
Enjoy your escape at the MCC.
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
Goodwin, Traci
3815 Nuthatcher Dr Date Due
Indianapolis, IN 46228
Invoice Invoice Description
or note attached invoice(s) Amount
Date Number e(s) or bill(s)) 19.00
7123110 482883 Refund
Total 19.00
I hereby certify that the attached invoice(s), or bilt(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.
Goodwin, Traci Allowed 20
3815 Nuthatcher Dr
Indianapolis, IN 46228
In Sum of$
19.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1096 -10 482883 4358400 19.00 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
12 &A &Mwun
Signature
19.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund