191406 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 364836 Page 1 of 1
ONE CIVIC SQUARE JENNIFER WEBER
CHECK AMOUNT: $27.00
CARMEL, INDIANA 46032 717 WOODRUFF PLACE EAST DRIVE
INDIANAPOLIS IN 46201 CHECK NUMBER: 191406
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 27.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 528200
Payment Date: 10/14/10
Household 17427
Monon Community Center Jennifer Weber Hm Ph: (248)227 -9383
Carmel IN 46032 717 Woodruff PI East Dr Wk Ph: (317)
Indianapolis IN 46201 Cell Ph: (248)227 -9383
jennifermw83 gmai I.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 27.00
Enrollee Name: Jennifer Weber Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 107800 -16 Community CPR- Adult 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/17/2010 (Cancelled)
Primary Instructor CCPR Staff
Class Location: Party Rooms A B Class Dates: 08/24/2010 to 08/26/2010
Monon Community Cntr 5-OOP to 8:30P
Tu,Th
Carmel, IN 46032 Scheduled Sessions: 2
(317)848 -7275
Cancel Reason. IOW enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 10/14/10 09:47:24 by MML FEES CHANGED ON CANCELLED ITEMS 27.00-
NET AMOUNT FROM CANCELLED ITEMS 27.OD-
TOTAL AMOUNT REFUNDED 27.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 27.00 Made By REFUND FINAN With Reference low enrollment
All refunds are subject to State Board of Accounts claim procedure and may t 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
da
Authorized Signature Date u rued ignature Date
O
IOU!' 2010
BY:
Page 1
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.
Weber, Jennifer Terms
717 Woodruff PI East Dr Date Due
Indianapolis, IN 46201
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10114110 528200 Refund 27.00
Total 27.00
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.£
20_
Clerk- Treasurer
Voucher No. Warrant No.
Weber, Jennifer Allowed 20
717 Woodruff PI East Dr
Indianapolis, IN 46201
in Sum of
27.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -50 528200 4358400 27.00 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
21 -Oct 2010
Signature
27.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund