188366 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: T359525 Page 1 of 1
ONE CIVIC SQUARE JENNIFER HUR
i 0 CHECK AMOUNT: $19.00
CARMEL, INDIANA 46032 50558 COPPERGATE DR
roe �o• CARMEL IN 46032 CHECK NUMBER: 188366
CHECK DATE: 813/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 480751 19.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 480751
j /r Payment Date: 7481 10
VIP? t�-� 1�'�
V Household 7481
roS5 6o pp en a-e- br. IAI
Monon Community Center Jennifer Hur Hm Ph: (317)815 -1576
Carmel IN 46032 Wk Ph: (317)274 -8742
r Cell Ph: (317)460 -5779
jrhur @iupui.edu
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 19.00
Enrollee Name: Garrett Hur Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 103002 12 Parent Child LA 2 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 05/06/2010 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Ind Leisure 1 Class Dates: 07/19/2010 to 07/28/2010
Monon Community Cntr 6:30P to 7:OOP
M,W
Carmel IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: Advanced Request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/20/10 12:47:41 by ERM FEES CHANGED ON CANCELLED ITEMS 26.00
SURCHARGE APPLIED AGAINST CANCELLED FEES O 7,00
NETIAMOUNTiFROMICANCELLEDNTMEMSI 1 A .19100
11 TWAVAMOU 5
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 19.00 Made By REFUND FINAN With Reference advanced request
Rewards Points refunded on this receipt: 0.70
Household Reward Point Balance: 8.70
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.
Authorized Signature Date Authorized Signature Date
Enjoy your escape at the MCC.
JUL 2 2010
BY!
Page 9 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.
Hur, Jennifer Terms
10558 Coppergate Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7120110 480751 Refund 19.00
Total 19.00
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.
Hur, Jennifer Allowed 20
10558 Coppergate Dr
Carmel, IN 46032
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 480751 4358400 19.00 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
29-Jul 2010
A
Signature
19.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund