HomeMy WebLinkAbout189494 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 364648 Page 1 of 1
ONE CIVIC SQUARE MELISSA ROBERTS
CARMEL, INDIANA 46032 12753 BRISTOW LANE CHECK AMOUNT: $91.00
FISHERS IN 46037
CHECK NUMBER: 189494
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 91.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 467730
Payment Date: 07/09/10
Household 34651
Morton Community Center Melissa Roberts Hm Ph: (317)501 -4136
Carmel IN 46032 12753 Bristow Lane
Fishers IN 46037 Cell Ph:
melissa.daniels @gmail.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 91.00
Enrollee Name: Melissa Roberts Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 107197 -01 Pottery 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 04/29/2010 (Cancelled)
Primary Instructor: Jeremy South
Class Location: Art Studio Class Dates: 07/15/2010 to 07/29/2010
Monon Community Cntr 6:15P to 9:15P
Th
Carmel, IN 46032 Scheduled Sessions: 3
(317)848 -7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/09/10 07:39:29 by MML FEES CHANGED ON CANCELLED ITEMS 98.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUNT FROM CANCELLED ITEMS 91.00
TOTAL AMOUNT REFUNDED 91.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 91.00 Made By REFUND FINAN With Reference advanced request
All refunds s jec St Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. N h r it c d refunds.
Au ize na re Date Auth6rized Signature Date
ti.
1010
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.
Roberts, Melissa Terms
12753 Bristow Lane Date Due
Fishers, IN 46037
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
719110 467730 Refund 91.00
Total 91.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Roberts, Melissa Allowed 20
12753 Bristow Lane
Fishers, IN 46037
In Sum of
91.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -50 467730 4358400 91.00 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
26 -Aug 2010
Signature
91.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund