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Home My WebLink About194379 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 365053 Page 1 of 1 0 f' ONE CIVIC SQUARE ANGIE THOMPSON CHECK AMOUNT: $179.20 CARMEL, INDIANA 46032 1540 COPPERWOOD CIRCLE E CARMEL IN 46032 CHECK NUMBER: 194379 CHECK DATE: 2/3/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 179.20 PARKS DEPARTMENT REFU PASS REFUND RECEIPT Receipt 567731 Payment Date: 01/26/11 Household 3168 Carmel Clay Parks Recreation Angie Thompson Hm Ph: (317)575 -8678 1235 Central Park Drive East 1540 Copperwood Circle E Wk Ph: (317)688 -2074 Carmel IN 46032 Carmel IN 46032 Cell Ph: (317)997-6498 athompson3 @clariannorth.com Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 171.00 Pass Holder: Angie Thompson Fees Tax Discount Prey Paid Cur Paid Amount Due Pass Type: Corp 10 HH Prim (CORP 10H), #106599 589.00 0.00 0.00 589.00 0.00 Valid Dates: 05/12/2010 to 05/12/2011 Pass Cancellation) Cancel Reason: Guest requested cancel on 11/17/10. Corp Pass. Company failed to send request until 1/25/11. CANCELLATION Pass Holder: Mike Thompson Feed+ Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Corp HH (CORP HH #62875 0.00 0.00 0.00 0.00 0.00 Valid Dates: 03/30/2010 to 04/03/2011 Pass Cancellation) Pass Comments: Children must be age 11 or older to utilize the pools and/or gymnasium unaccompanied by an adult. Children ages 11 -13 may use Fitness Center, but must be under adullt supervision. Children must be age 14+ to utilize the Fitness Center without adult supervision. Cancel Reason: Guest requested cancel on 11117110. Corp Pass. Company failed to send request until 1/25/11. CANCELLATION Pass Holder: Kelsie Thompson Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Corp HH (CORP HH #62876 0.00 0.00 0.00 0.00 0.00 Valid Dates: 03/30/2010 to 04/03/2011 Pass Cancellation) Cancel Reason: Guest requested cancel on 11/17/10. Corp Pass. Company failed to send request until 1/25/11. CANCELLATION Pass Holder: Maxwell Thompson Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Corp HH (CORP HH #62877 0.00 0.00 0.00 0.00 0.00 Valid Dates: 03/30/2010 to 04/03/2011 Pass Cancellation) Cancel Reason: Guest requested cancel on 11117110. Corp Pass. Company failed to send request until 1/25111. CANCELLATION Pass Holder: Carrie Harlan Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Corp HH (CORP HH #62878 0.00 0.00 0.00 0.00 0.00 Valid Dates: 03/30/2010 to 04/03/2011 Pass Cancellation) Cancel Reason: Guest requested cancel on 11/17/10. Corp Pass. Company failed to send request until 1125/11. Page 1 PASS REFUND RECEIPT Receipt 567731 Payment Date: 01/26/2011 Household 3168 PREVIOUS NET CREDIT HOUSEHOLD BALANCE 8.20 Processed on 01126/11 09:42:34 by ABK FEES CHANGED ON CANCELLED ITEMS 760.00 SURCHARGE APPLIED AGAINST CANCELLED FEES O 589.00 1. NET AMOUNT FROM CANCELLED ITEMS 171.00 HH BALANCE APPLIED TO THIS RECEIPT 0- ::TOTAL AMOUNT REFUNDED 179:20 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 179.20 Made By REFUND FINAN With Reference Corp Pass 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 r credit card refunds. Authorized Signat re Date Authorized 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). 7 JAN 2 f 2011 By Page 2 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. Thompson, Angie Terms 1540 Copperwood Circle E Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1126111 567731 Refund 179.20 Total 179.20 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 1 20 Clerk Treasurer Voucher No. Warrant No. Thompson, Angie Allowed 20 1540 Copperwood Circle E Carmel, IN 46032 In Sum of 179.20 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1092 567731 4358400 179.20 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 27 -Jan 2011 Signature 179.20 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund