HomeMy WebLinkAbout193782 01/19/2011 CITY OF CARMEL, INDIANA VENDOR: 365026 Page 1 of 1
ONE CIVIC SQUARE MARY HIGGINS
CARMEL, INDIANA 46032 715 EAST 111TH S7 CHECK AMOUNT: $10.00
INDIANAPOLIS IN 46280
o CHECK NUMBER: 193782
CHECK DATE: 1/19/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 10.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 559371
Payment Date: 01/10/11
Household 32257
Monon Community Center Mary Higgins Hm Ph: (317)816-0794
Carmel IN 46032 39 waedlamd [+f Wk Ph: (317)688
V 1C)ta416JX45 Cell Ph:
mehiggins48 @yahoo.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 10.00
Enrollee Name: Mary Higgins Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 314505 -02 Intro to Free Weight 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 01/03/2011 (Cancelled)
Class Location: Fitness Center Class Dates: 01/15/2011 to 0 1/15/2011
Monon Community Cntr 12:00P to 1:00P
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: Low Enrollment.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 01/10/11 12:09:49 by LWW FEES CHANGED ON CANCELLED ITEMS 10.00
NET AMOUNT FROM CANCELLED ITEMS 10.00
TOTAL AMOUNT REFUNDED 10,00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 10.00 Made By REFUND FINAN With Reference Check
All refunds are subject to State Board of Accounts claim procedure and may take w ks to process. A check will be
issued. No cash or credit card refunds.
1�111�. .Q0�1 CG
Authorized Signature Date u! o Signature Date
Mothers, bring your little prince to Prince Charming's Ball and share a Valentine's evening of enchantment and wonder at this
ballroom -style event. The event will be held on Friday, February 4 from 6 -9pm at the MCC. Fee is $15 /person. Register at
www.carmelclayparks.com. Pre registration is required (activity# 319047 -01).
JAN
td9 to. 22. 435 8' 0 o
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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.
Higgins, Mary Terms
715 East 111th Street Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1110111 559371 Refund 10.00
Total 10.00
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.
Higgins, Mary Allowed 20
715 East 111 th Street
Indianapolis, IN 46280
In Sure of
10.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT#MTLE AMOUNT Board Members
Dept
1096 -22 559371 4358400 10.00 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
13 -Jan 2011
Signature
10.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund