HomeMy WebLinkAbout190960 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 364785 Page 1 of 1
0 ONE CIVIC SQUARE JENNIFER SKULSKI
CARMEL, INDIANA 46032 7489 NORTH ILLINOIS CHECK AMOUNT: $185.50
INDIANAPOLIS IN 46260 CHECK NUMBER: 190960
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CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 526640 185.50 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 526640
Payment Date: 10/07/10
Household 37371
Monon Community Center Jennifer Skulski Hm Ph: (317)251 -3070
Carmel IN 46032 7489 North Illinois
Indianapolis IN 46260 Cell Ph:
mjskulski @aol.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 20.50
Enrollee Name: Matt Skulski Fees Tax Mom Prey Paid Cur Paid Amount Due
Activity Number. 205121 -01 Mom -N-Me Gymnastics 34.50 0.00 0.00 34.50 0.00
Enrollment Date: 09/02/2010 (Cancelled)
Class Location: Fitness Studio B Class Dates: 09/07/2010 to 09/28/2010
Monon Community Cntr 10:30A to 11:OOA
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: prorated request
CANCELLATION Refund Of 55.00
Enrollee Name: Matt Skulski Fees Tax Discount Prey Paid Cur Paid Amount Due
Activity Number. 205121 -03 Mom -N -Me Gymnastics 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09/0212010 (Cancelled)
Class Location: Fitness Studio B Class Dates: 10105/2010 to 1012612010
Monon Community Cntr 10:30A to 11:OOA
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: advanced request
CANCELLATION Refund Of 55.00
Enrollee Name: Matt Skulski Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 205121 -05 Mom -N-Me Gymnastics 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09/02/2010 (Cancelled)
Class Location: Fitness Studio B Class Dates: 11/02/2010 to 11/23/2010
Monon Community Cntr 10:30A to 11 .00A
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: advanced request
CANCELLATION Refund Of 55.00
Enrollee Name: Matt Skulski Fees Tax Discount Prey Paid Cur Paid Amount Due
Activity Number. 205121 -07 Mom -N -Me Gymnastics 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09/0212010 (Cancelled)
Page 1
ACTIVITY REFUND RECEIPT
Receipt 526640
Payment Date: 10/07/2010
Household 37371
Class Location: Fitness Studio B Clams Dates: 11/30/2010 to 12/21/2010
Monon Community Cntr 10:30A to 11:00A
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 10/07/10 10 :13:40 by CNA FEES CHANGED ON CANCELLED ITEMS 220.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 34.50
NET AMOUNT FROKCANCELLED ITEMS .85.50-
TOTAL AMOUNT REFUNDED 185.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 185.50 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 r e funds. /n
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Auth 'zed Signature Date 1 Authom&6d 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 1 dam -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.
Skulski, Jennifer Terms
7489 North Illinois Date Due
Indianapolis, IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1017110 526640 Refund 185.50
Total 185.50
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.
Skulski, Jennifer Allowed 20
7489 North Illinois
Indianapolis, IN 46260
In Sum of
185.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1096 -32 526640 4358400 185.50 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
185.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund