HomeMy WebLinkAbout188583 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 364509 Page 1 of 1
ONE CIVIC SQUARE ANNE MARIE WILLIAMS CHECK AMOUNT: $128.00
CARMEL, INDIANA 46032 12344 BARNSTONE CT
FISHERS IN 46037 CHECK NUMBER: 188583
CHECK DATE: 8/312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 480974 128.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 480974
Payment Date: 07/20/10
Household 30610
Monon Community Center Anne Marie Williams Hm Ph: (317)842 -3862
Carmel IN 46032 yq .4.3828- Wabo -q rim
_.F46�ers- N Cell Ph:
6( ST"iJC T annemarie.williams@att.net
(317)848 -7275
Fed Tax ID #35- 6000972 R�f y(
Enrollment Details
CANCELLATION Refund Of 128.00
Enrollee Name: Jackson Williams Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -13 Vacation Station 32.00 0.00 32.00 0.00 0.00
Enrollment Date: 03/1212010 (Cancelled)
Class Location: Clay Middle School Class Dates: 06/14/2010 to 06/18/2010
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: unable to attend tues -fri (due to injury occurred outside of camp)
PREVIOUS NET HOUSEHOLD BALANCE 20.00
Processed on 07/20/10 17:07:40 by BJJ FEES CHANGED ON CANCELLED ITEMS 128.00
NET AMOUNT FROM CANCELLED ITEMS 128.00
TOTAL AMOUNT REFUNDED 128.00
NEW NET HOUSEHOLD BALANCE 20.00
Refund of 128.00 Made By R EFUND FINAN With Reference
All refund are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A II be
issued. N cash or credit card refunds.
t oriz ignature Date Authorized Signature Date
Enjoy your escape at the MCC.
qMYOO I JUL 2 1 2010
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.
Williams, Anne Marie Terms
12344 Barnstone Ct Date Due
Fishers, IN 46037
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/20/10 480974 Refund 128.00
Total 128.00
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.
Williams, Anne Marie Allowed 20
12344 Barnstone Ct
Fishers, IN 46037
In Sum of
128.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1082 -1 480974 4358400 128.00 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
Signature
128.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund