190368 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 363431 Page 1 of 1
ONE CIVIC SQUARE CAMERON LUO
t
CARMEL, INDIANA 46032 12715 COVERED BRIDGE ROAD CHECK AMOUNT: $47.00
SELLERSBURG IN 47372 CHECK NUMBER: 190366
CHECK DATE: 9129/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1096 4358400 47.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 523697
Payment Date: 09/23/10
Household 30916
Monon Community Center Cameron Luo Hm Ph: (812)246 -1164
Carmel IN 46032 12715 Covered Bridge Rd.
Sellersburg IN 47172 Cell Ph:
csluo@hotmail.com
Phone: (317)848 -7275
FP,d Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 47.00
Enrollee Name: Cameron Luo 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
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09123/10 10:56:44 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 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 rd refunds.
to 9,13. 16
A u i h o rized Signature y ate Au oriie\Sig ature Date
Iv 6. z
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 1 Oam -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.
t Stt' Z 2010
B Y:
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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.
Luo, Cameron Terms
12715 Covered Bridge Rd. Date Due
Sellersburg, IN 47172
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9123110 523697 Refund 47.00
Total 47.00
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
Luo, Cameron Allowed 20
12715 Covered Bridge Rd.
Sellersburg, IN 47172
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 523697 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