HomeMy WebLinkAbout190746 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 364783 Page 1 of 1
ONE CIVIC SQUARE JAMIE FERENCY CHECK AMOUNT: $53.50
CARMEL, INDIANA 46032 3821 BRASSEUR LANE
CARMEL IN 46033 CHECK NUMBER: 190746
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4358400 53.50 PARKS REFUND
FACILITY REFUND RECEIPT
Receipt 515245
Payment Date: 09(01110
Household 491
Monon Community Center F R F y Hm Ph: (317)571 -1091
Carmel IN 46032 3821 Brasseur Lane
Carmel IN 46033 Cell Ph:
jl ferency23 @comcast.net,jonferency @msn.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Facility Reservation Details
CANCELLATION Refund Of 53.50
Facility River Heritage, River Heritage
Reserv.Contact Jamie Ferency, HM: (317)571 -1091
Reserv. Number 12897 Status: Cancelled
Purpose. CHS Cross Country Reunion
Anticipated Count 45
D ale Day Time Fees r- Tax Discount Prev Paid Cur Paid Amount Due
0810712010 Sal 7:00A to 8:00P 0.00 0.00 0.00 0.00 0.00
Cancel Reason. Large family had settled in shelter and Jamie was unable to use shelter and felt the party too
large and too involved to ask them to leave.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/01(10 20'25 32 by MCC FEES CHANGED ON CANCELLED ITEMS 50.00
SALES TAX CHARGED ON CANCELLED FEES 3.50
Q 7L NET AMOUNT FROM CANCELLED ITEMS 53:50
/0 3 q 3E 6 TOTAL AMOUNT REFUNDED 53.50
NFW NET HOUSEHOLD BALANCE 0.00
Refund of 53.50 Made By REFUND FINAN With Reference check
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.
The count for this line item will not be known until after the reservation dale. Therefore, both the count and the extension are
left at zero for reservation purposes, but will be updated after the reservation date. As soon as this data is available, you will
be invoiced for the current amount due. Please remit to our office within 10 days of the invoice date.
Authorized Si alure Date Authorized Signature Dale
Don't forget to register for St.Vincent Tour de Carmel taking place on Saturday, September 11. Visit
www.carrnelclayparks.com for more information or httpsalr(, to register!
If you have already registered for the event, you may pick up your goodie bag at the MCC East Building on September 7 from
5 -8pm, September 8 from 9am -1 pm, or September 9 from 5 -8pm. qM �g�
S &LC)2010
Page 11 1
BY:
�S
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.
Ferency, Jamie Terms
3821 Brasseur Lane Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9123110 515245 Refund 53.50
Total 53.50
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.
Ferency, Jamie Allowed 20
3821 Brasseur Lane
Carmel, IN 46033
In Sum of
53.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1095 -3 515245 4358400 53.50 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
53.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund