190460 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364747 Page 1 of 1
ONE CIVIC SQUARE SUZIE SENCAJ CHECK AMOUNT: $174.00
CARMEL, INDIANA 46032 10730 TORREY PINES CIRCLE
CARMEL IN 46032 CHECK NUMBER: 190460
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 174.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 523707
Payment Date: 09/23/10
Household 7708
Monon Community Center Suzie Sencaj Hm Ph: (317)575 -8085
Carmel IN 46032 10730 Torrey Pines Cir Wk Ph: (317)
Carmel IN 46032 Cell Ph: (317)709 -0613
dssencaj@aol.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 87.00
Enrollee Name: John Sencaj Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 207600 -02 The MCC Fall Open 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09121/2010 (Cancelled)
Class Location: Gymnasium A Class Dates: 09/25/2010 to 09/25/2010
Monon Community Cntr 8:OOA to 6:OOP
Sa
Carmel IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: IOW enrollment
CANCELLATION Refund Of 87.00
Enrollee Name: Michael Sencaj Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 207600 -02 The MCC Fall Open 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09121/2010 (Cancelled)
Class Location: Gymnasium A Class Dates: 09/25/2010 to 09/25/2010
Monon Community Cntr 8:OOA to 6:OOP
Sa
Carmel IN 46032 Scheduled Sessions: 1
(317)848 7275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/23/10 11:18:39 by MML FEES CHANGED ON CANCELLED ITEMS 174.00
NET AMOUNT FROM CANCELLED ITEMS 174.00
TOTAL AMOUNT REFUNDED 174.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 174.00 Made By REFUND FINAN With Reference low enrollment
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. N ca h r credit card refunds.
q. 23.10
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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.
Sencaj, Suzie Terms
10730 Torrey Pines Cir Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9123110 523707 Refund 174.00
Total 174.00
I hereby certify that the attached invoice(s), or bills) 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,
Sencaj, Suzie Allowed 20
10730 Torrey Pines Cir
Carmel, IN 46032
In Sum of
174.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -50 523707 4358400 174.00 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
174.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund