190269 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364733 Page 1 of 1
ONE CIVIC SQUARE DALE GARDNER CHECK AMOUNT: $47.00
CARMEL, INDIANA 46032 205 MAPLE SHADE DRIVE
TYRONE CA 30290 CHECK NUMBER: 190269
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 47.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 523691
Payment Date: 09/23/10
Household 37489
Monon Community Center Gardner Dale Hm Ph: (770)265 -9471
Carmel IN 46032 205 Maple Shade Dr.
Tyrone GA 30290 Cell Ph:
drake.gardner.dale@gmail.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 47.00
Enrollee Name. Gardner Dale Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 207600 -01 The MCC Fall Open 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09/08/2010 (Cancelled)
Class Location: Gymnasium A Class Dates: 09/25/2010 to 09/25/2010
Monon Community Cntr 8:00A to 6:OOP
Sa
Carmel IN 46032 Scheduled Sessions: 1
(317)848 -7275
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/23/10 10:48:26 by MML FEES CHANGED ON CANCELLED ITEMS 47.00
NET AMOUNT FROM CANCELLED ITEMS 47.00-
TOTAL AMOUNT REFUNDED 47.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 47.00 Made By REFUND FINAN With Reference low enrollment
All refunds are sub' ct to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issuedWcacre 25 t card refunds. q.z3.10
Au Date u3 orized gnature Date
�o5�.5a-(35066
The Monon Community Center is a one -stop shop! Why drive all day searching for your local garage sale? Come to our
Community Garage Sale and leisurely browse through all sorts of items. The Community Garage Sale will take place Saturday,
October 9 from 10am -4pm at the MCC East Parking Lot. The event is free to the public.
Vendors: The fee for vendors is $5 /parking space. You Trust bring a table /chair. A limited number of tables and chairs will be
available at an additional cost of $5 each. In case of inclement weather, this event will be cancelled. To register, please
contact Sarah or fax your form to 317.573.5243.
TVI
K
S EP 2 7 2010
IU A;
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.
Dale, Gardner Terms
205 Maple Shade Dr Date Due
Tyrone, GA 30290
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9123/10 523691 Refund 47.00
Total 47.00
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- 1D -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
Dale, Gardner Allowed 20
205 Maple Shade Dr
Tyrone, GA 30290
In Sum of
47.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -50 523691 4358400 47.00 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
27 -Sep 2010
Signature
47.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund