190294 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364738 Page 1 of 1
ONE CIVIC SQUARE STEVEN HARLESS CHECK AMOUNT: $15.00
�t4 CARMEL, INDIANA 46032 9632 CEDAR POINT DRIVE
CARMEL IN 46032 CHECK NUMBER: 190294
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 15.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 523093
Payment Date: 09/20/10
Household 7110
Monon Community Center Steven Harless Hm Ph: (317)441 -8365
Carmel IN 46032 9632 Cedar Point Dr. Wk Ph: (317)407 -0425
Carmel IN 46032 Cell Ph: (317)407 -0425
Phone: (317)848 -7275 susanhariess@sbcglobal.net
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 15.00
Enrollee Name: Colleen Harless Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486062 -03 Tumbling 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09/24/2008 (Cancelled)
Class Location: Orchard Park Elem Class Dates: 10102/2008 to 10/1612008
Orchard Park Element 2:45P to 3:45P
10404 Orchard Park Drive South Th
Indianapolis, IN 46280 Scheduled Sessions: 3
(317)848 -7275
Cancel Reason: class cancelled due to low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/20/10 15:31:43 by BJJ FEES CHANGED ON CANCELLED ITEMS 15.00
NET AMOUNT iF.ROMCANCELL'ED,ITEMS, 15300
TOTAL AMOUNT REFUNDED;
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 15.00 Made By REFUND FINAN With Reference
All refunds re subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. N cash or credit card refunds.
7
A thor' d Signature Date Authorized Signature Date
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 must 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.
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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.
Harless, Steven Terms
9632 Cedar Point Dr. Date Due
Carmel, I N 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9120/10 523093 Refund 15.00
Total 15.00
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
1 20
Clerk- Treasurer
Voucher No, Warrant No.
4Harless, Steven Allowed 20
9632 Cedar Point Dr.
Carmel, IN 46032
In Sum of
15.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -99 523093 4358400 15.00 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
23 -Sep 2010
Signature
15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund