HomeMy WebLinkAbout196941 04/26/2011 CITY OF CARMEL, INDIANA VENDOR: 365248 Page 1 of 1
0 ONE CIVIC SQUARE TIM SHURR
CARMEL, INDIANA 46032 14487 HEATHER KNOLL PARKWAY CHECK AMOUNT: $90.00
WESTFIELDIN 46074
CHECK NUMBER: 196941
CHECK DATE: 4126/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 90.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 601643
Payment Date: 04/14/11
Household 36312
Monon Community Center Tim Shurr Hm Ph: (219)263 -8990
Carmel IN 46032 14487 Heather Knoll Pkway
Westfield IN 46074 Cell Ph:
sassyshurr @yahoo.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 35.00
Enrollee Name: Aiden Shurr Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 113005 -18 Preschool Level 3 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 04/02/2011 (Cancelled)
Class Location: Ind Leisure 4 Class Dates: 06/20/2011 to 06/23/2011
Monon Community Cntr 9:OOA to 9:45A
M,Tu,W,Th
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: Advanced Request
CANCELLATION Refund Of 55.00
Enrollee Name: Max Shurr Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 113006 -13 Learn to Swim Lvi 1 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04102/2011 (Cancelled)
Class Location: Indoor Lap Pool 1 Class Dates: 06/20/2011 to 06/23/2011
Monon Community Cntr 10:OOA to 10:55A
M,Tu,W,Th
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: Advanced Request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 04/14/11 12:50:43 by ERM FEES CHANGED ON CANCELLED ITEMS 97.00
9 W SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
APR 15- 1011
�6' t=1 NETrtAMOUNT-E „ROM, o�..
..G�' .�TiOTi4L�AMOUNTG'REFUNDED, �.�r�;r "w.,.,90�00t
/'rte 4
l! BY:
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 90.00 Made By REFUND FINAN With Reference Advanced Request
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.
Authorized Signature Dati Authorized Signature Date
l0 K'�i�YC� 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.
Shurr, Tim Terms
14487 Heather Knoll Pkway Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/14/11 601643 Refund 90.00
Total 90.00
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.
Shurr, Tim Allowed 20
14487 Heather Knoll Pkway
Westfield, IN 46074
In Sum of
90.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -10 601643 4358400 90.00 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
90.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund