HomeMy WebLinkAbout195533 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 365170 Page 1 of 1
0 ONE CIVIC SQUARE ANDREW LEBLANC CHECK AMOUNT: $52.00
CARMEL, INDIANA 46032 11495 CHATEAUX DRIVE
CARMEL IN 46032 CHECK NUMBER: 195533
CHECK DATE: 3/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 52.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 582557
Payment Date: 02/28/11
Household 38909
Morton Community Center Andrew LeBlanc Hm Ph: (516)458 -1733
Carmel IN 46032 11495 Chateaux Drive
Carmel IN 46032 Cell Ph: (516)458 -1733
melissaleblanc99 yahoo.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 52.00
Enrollee Name: Madeline LeBlanc Fees Tax Discount Prev Paid Cur Paid Amount Dug
Activity Number: 316371 -03 Cheerleading 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/17/2011 (Cancelled)
Primary Instructor: Fitness on the Move
Class Location: Program Room A Class Dates: 03/0212011 to 03/23/2011 y 6
Morton Community Cntr 4:45P to 5:30P
W 6 a� q
Carmel IN 46032 Scheduled Sessions: 4 FEB 2 1011
(317)848 7275
Cancel Reason: low enrollment BY:
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 02/28/11 12:37:26 by LVA FEES CHANGED ON CANCELLED ITEMS 52.00
NET, AMOUNT FROM CANCELLED ITEMS• 52:00
TOTAL�AMQUNT'REFUNDED 52.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 52.00 .Made By REFUND FINAN With Reference low enrollment
All refunds are subject to State Board of Accounts claim procedure and mar e we ks to process. A check will be
is No cash or credit card refunds.
rte-- O 2
horized Sign n Dat 1`rized Sign ture D6
Sign up now or volunteer for our Dime Carnival taking place on March 5, from 6 -9pm in the MCC Banquet Rooms. There will
be at least 15 different types of games appropriate for ages 3 -12 years old. The number of tickets required to play varies for
each game. You may play your favorite game as often as you would like; just make sure you don't run out of tickets. Tickets
are 10 cents each, put you may purchase by the dollar. Visit carmelclayparks.com for ticket numbers and pricing.
Ot-
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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.
LeBlanc, Andrew Terms
11495 Chateaux Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice {s) or bill(s)} Amount
2128111 582557 Refund 52.00
Total 52.00
l 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.
LeBlanc, Andrew Allowed 20
11495 Chateaux Drive
Carmel, IN 46032
In Sum of$
52.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -42 582557 4358400 52.00 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.
10 -Mar 2011
Signature
52.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund