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Home My WebLink About196929 04/26/2011 CITY OF CARMFL, INDIANA VENDOR: 365246 Page 1 of 1 ONE CIVIC SQUARE JAY RUDOLPH CHECK AMOUNT: $15.00 CARMFL, INDIANA 46032 10784 BELAIR DRIVE INDIANAPOLIS IN 46290 CHECK NUMBER: 196929 CHECK DATE: 4!2612011 DEPARTME ACCOUNT PO NUMBE I NVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 15.00 REFUNDS AWARDS INDE LOCKER REFUND RECEIPT Receipt# 600674 Payment Date: 04/12/11 Household 8959 Monon Community Center Jay Rudolph Hm Ph: (317)270 -2364 Carmel IN 46032 10784 Belair Drive Wk Ph: (317)230 -8851 Indianapolis IN 46280 Cell Ph: Phone: (317)848 -7275 dz4g9d @yahoo.com Fed Tax ID #35- 6000972 Locker Registration Details: RESERVATION CHANGE Refund Of 15.00 Member Name: Jay Rudolph Fees Tax Discount Prev Paid Cur Paid Amount Due Locker Room: Fitness Center Men's 120.00 0.00 120.00 0.00 0.00 Locker Number: 86 Valid Dates: 08/03/10 to 08/03/11 New Registration) PREVIOUS NET HOUSEHOLD BALANCE 0.00 J Processed on 04/12/11 09:43:50 by LWW FEES ADJUSTED ON CHANGED ITEMS 15.00 p .CSC &OL `v-&- plc�L32' L`�b a tN� u1 e1�r1_ `NET AMOUNT FROM.CHANGE ©'ITEMS TOTAL- AMOUNT:,REFUNDEi] ",moo,,'?,/ NEW NET HOUSEHOLD BALANCE 0 "00 Refund of 15.00 Made By REFUND FINAN With Reference Check refund All refunds are subject to State Board of Accounts claim procedure and may take 4- weeks to process. A check will be issued. No cash or credit card refunds. t Authorized Signature Date Auth ri d Sign re Date Hop on over to West Park for our annual Children's and Doggie Egg Hunts! The hunts will be filled with egg citing activities. Children will be divided into their appropriate age groups: 0 -2 years, 3 -5 years, 6 -8 years, and 9 -11 years. Dogs will be divided based on weight 0 -25 Ibs and 26+ lbs. All dogs are required to be on a leash at all times. Both events are held outside, rain or snow. There is no online or pre registration; you must register the day of. Saturday, April 16 D Children's 10 :30am, $1 /child �F d7 Doggie 1lam, $3 /dog West Park, 2700 W 116th Street A P R 1 4 20 I IEJ B Y Page 1 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be property itemized must show, k n d of s price performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, Payee Purchase Order No. Terms Rudolph, Jay Date Due 10784 8elair Drive Indianapolis, IN 46280 Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s) 15.00 4112111 600674 Refund Total 15,00 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- 14 -1.6 20� Clerk- Treasurer Voucher No. Warrant No. Rudolph, Jay Allowed 20 10784 Belair Drive Indianapolis, IN 46280 In Sum of 15.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members Dept 1096 -22 600674 4358400 15.00 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 21 -Apr 2011 Signature 15.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund