HomeMy WebLinkAbout192137 11/23/2010 F CITY OF CARMEL, INDIANA VENDOR: 364879 Page 1 of 1
4 ONE CIVIC SQUARE MATT KIEFFER CHECK AMOUNT: $125.00
CARMEL, INDIANA 46032 3940 WOODCREST COURT
NOBLESVILLE IN 46062 CHECK NUMBER: 192137
CHECK DATE: 11123/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 125.00 PARRS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 537110
Payment Date: 11/11/10
Household 22993
Monon Community Center Matt Kieffer Hm Ph: (317)896 -8711
Carmel IN 46032 3940 Woodcrest Court
Noblesville IN 46062 Cell Ph: (317)385-2346
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 125.00
Enrollee Name: Matt Kieffer Fees Tax DiscounE Prey Paid Cur Paid Amount Due
Activity Number: 293019 -02 Water Safety Instruc 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 10/10/2009 (Cancelled)
Class Location: Indoor Lap Pool Class Dates: 11/10/2009 to 12/08/2009
Monon Community Cntr 4:30P to 9:30P
Tu,Th
Carmel IN 46032 Scheduled Sessions: 7
(317)848 -7275
Skip Days 11 /2412009, 11/26/2009
Cancel Reason: Reimbursement for WSI class per Tess Pinter
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 11111110 13:03:34 by ERM FEES CHANGED ON CANCELLED ITEMS I. NET AMOUNT FROM CANCELLED ITEMS '125.00-
TOTAL AMOUNT REFUNDED 125.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 125.00 Made By REFUND FINAN With Reference Reimbursement; Per Tess Pinter
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.
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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.
Kieffer, Matt Terms
3940 Woodcrest Court Date Due
Noblesville, IN 46062
Invoice Invoice Description
Date Number {or note attached invoice(s) or bill(s)) Amount
11111/10 537110 Refund 125.00
Total 125.00
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.
Kieffer, Matt Allowed 20
3940 Woodcrest Court
Noblesville, IN 46062
In Sum of
125.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -10 537110 4358400 125.00 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
18 -Nov 2010
Signature
125.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund