190724 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 364780 Page 1 of 1
ONE CIVIC SQUARE DEBORAH DELROSARIO
CARMEL, INDIANA 46032 13300 KICKAP00 TRAIL CHECK AMOUNT: $48.00
CARMEL IN 46033 CHECK NUMBER: 190724
ON
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 48.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 526512
Payment Date: 10/06/10
Household 37060
Monon Community Center I Deborah Delrosario
Carmel IN 46032 O C T 0 7 20 13300 Kickapoo Trail
Carmel IN 46033 Cell Ph:
debdet188 @msn.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972 �Y'
Enrollment Details
CANCELLATION Refund Of 48.00
Enrollee Name: Marisa McQuillan Fees Tax Discount Prey Paid Cur Paid Amount Due
Activity Number. 205259 -05 Preschool Gymnastics 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 09/2912010 (Cancelled)
Class Location: Fitness Studio B Class Dates: 11/02/2010 to 11/23/2010
Monon Community CMr 11:15A to 11:45A
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 10/06/10 15:27:09 by CNA FEES CHANGED ON CANCELLED ITEMS 55.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET,AMOUNT:FROM CANCELLED ITEMS 48.00
TOTAL AMOUNT REFUNDED 48.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 48.00 Made By REFUND FINAN With Reference advanced request
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
Aufl6zed 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.
Delrosario, Deborah Terms
13300 kickapoo Trail Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1016110 526512 Refund 48.00
Total 48.00
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.
Delrosario, Deborah Allowed 20
13300 kickapoo Trail
Carmel, IN 46033
In Sum of
48.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -32 526512 4358400 48.00 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
7 -Oct 2010
Signature
48.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund