HomeMy WebLinkAbout189523 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 364649 Page 1 of 1
ONE CIVIC SQUARE JENNIFER SULLIVAN
q 0 CHECK AMOUNT: $61.81
CARMEL, INDIANA 46032 25 FLORENCE STREET
CARMEL IN 46033 CHECK NUMBER: 189523
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 61.81 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 511631
Payment Date: 08/23/2010
Household 9: 31865
Home Phone: (317)519 -1931
JENNIFER SULLIVAN Monon Community Center
25 FLORENCE ST Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID 435- 6000972
Pass Details
CANCELLATION Refund Of 61.81
Pass Holder: Jennifer Sullivan Fees Tax Discount Prey Paid Cur Paid Amount Due
Pass Type: FIT Adlt Mnthly (XM FTAM), #88475 178.19 0.00 0.00 178.19 0.00
Valid Dates: 11/25/2009 to 11/25/2010 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
nMonthly Fitness Pas 178.19 1.00 0.00 0.00 178.19
Cancel Reason: k not Us!n9 ever.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/23/10 19:18:04 by TLP FEES CHANGED ON CANCELLED ITEMS 240.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES O 178.19
NET AMOUNT FROM CANCELLED'ITEMS 61.81-
TOTAL AMOUNT REFUNDED 61.81
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 61.81 Made By REFUND FINAN With, Reference
All refunds are subject to St, to B and of A ount aim procedure and may take 4 -6 weeks to process. A check will be
issu No r
ed. credit card funds.
J Au 1hdrized Signature Date Authorized Signature Date
ENJOY YOUR ESCAPE!!! r AUG 5 2010
BY......
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.
Sullivan, Jennifer Terms
25 Florence St Date Due
Carmel, IN 46033
Invoice Number Invoice Description
Date
or note attached invoices) or bill(s)) Amount
61.81
8123110 511631 Refund
Total 61.81
1 hereby certify that the attached invoice(s): or bill(s) is (are) true and correct and I have audited same �n accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
Sullivan, Jennifer Allowed 20
25 Florence St
Carmel, IN 46033
In Sum of
61.81
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT /TITLE AMOUNT Board Members
Dept
1092 511631 4358400 61.81 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
61.81 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund