192523 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 364911 Page 1 of 1
ONE CIVIC SQUARE JOE ORLANDO
CARMEL, INDIANA 46032 11224 ARMON DRIVE CHECK AMOUNT: $29.00
CARMEL IN 46033
CHECK NUMBER: 192523
CHECK DATE: 12/712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 543860 29.00 REFUNDS AWARDS TNDE
ACTIVITY REFUND RECEIPT
Receipt 543860
Payment Date: 11/30/10
Household 38269
Monon Community Center D f Joe Orlando Hm Ph: (317)603 -5462
Carmel IN 46032 11224 Armon Dr
N OV a polo
z Carmel IN 46033 Cell Ph:
terrasiniboy @yahoo.com
Phone: (317)848-7275
Fed Tax ID #35- 6000972 BY:
Enrollment Details
CANCELLATION Refund Of 14.00
Enrollee Name: Joe Orlando Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 204275 -02 At -Home Holiday W.O. 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 1111112010 (Cancelled)
Class Location: Fitness Studio B Class Dates: 12/07/2010 to 12/07/2010
Monon Community Cntr 6:OOP to 7:OOP
Tu
Carmel IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: Low enrollment
CANCELLATION Refund Of 15.00
Enrollee Name: Joe Orlando Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 204730 -02 Care Conditioning 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 11/11/2010 (Cancelled)
Class Location. Fitness Studio B Class Dates: 12/03/2010 to 12/03/2010
Monon Community Cntr 12:OOP to 1:00P
F
Carmel IN 46032 Scheduled Sessions: 1
(31.7)848 -7275
Cancel Reason: Low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed.on 11/30/10 @a 08:44:37 by LWW FEES CHANGED ON CANCELLED ITEMS_( 29.00
NET AMOUNT FROM- CANCELLEDITEMS
TOTALAMOUNT REFUNDED 29.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 29.00 Made By REFUND FINAN With Reference Check refund
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. f
LU�,�Q,Q, 1 1.30.10 L 1 �a 30. �b
Authorized Signature Date Au h ized S nature Date
109 2 5- a 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,
Orlando, Joe Terms
11224 Armon Dr Date Due
Carmel, IN 46033
invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11130110 543860 Refund 29.00
Total 29.00
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.
Orlando, Joe Allowed 20
11224 Armon Dr
Carmel, IN 46033
In Sum of
29.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NQ ACCT #/TITLE AMOUNT Board Members
Dept
1096 -22 543860 4358400 29.00 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
2 -Dec 2010
Ch &M� M
Signature
29.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund