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Home My WebLink About197846 05/26/2011 CITY OF CARMEL, INDIANA VENDOR: 365302 Page 1 of 1 ONE CIVIC SQUARE TJ TRYON i 7 1' CHECK AMOUNT: $37.08 CARMEL, INDIANA 46032 1118 RUTLEDGE CT NOBLESVILLE IN 46062 CHECK NUMBER: 197846 CHECK DATE: 5/26/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 611512 37.08 REFUNDS AWARDS INDE PASS REFUND RECEIPT Receipt 611512 Payment Date: 05/05/11 Household 32833 Monon Community Center TJ Tryon Hm Ph: (317)774 -8762 Carmel IN 46032 1118Rutledge Ct Noblesville IN 46062 Cell Ph: tj @coachj.com Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 37.08 Pass Holder: TJ Tryon Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: MC Adlt Annual (M MCAA), #126887 137.92 0.00 137.92 0.00 0.00 Valid Dates: 01/06/2011 to 06/06/2011 Pass Cancellation) Cancel Reason: priveleges revoked per SB. PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 05/05/11 14:47:39 by SMB FEES CHANGED ON CANCELLED ITEMS 37.08 NET AMOUNT FROM CANCELLED ITEMS 37.08- TOTAL AMOUNT REFUNDED 37.08 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 37.08 Made By REFUND FINAN With Reference pass revoked refund 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. 5 [51 Authorized Signature Date Authorized Signature Date Load up the kids, dig out your tents, and head over to West Park for our Family Campout. Campers will chow down on tasty camping classics such as beans, hotdogs, and hamburgers. Then we will all enjoy family games, and a movie under the stars. The film will be How to Train Your Dragon (PG). Night owls are then invited to join a late night hike around the park. Participants must bring their own tent, bug spray, and flashlights- we will provide the rest. Fee includes dinner, a light breakfast, and all activities. Tent setup is between 4:30 and 6:00pm. Pre registration is required. In case of inclement weather, the rain date will be June 17 -18. Please call Sarah with any special requests due to allergies /vegetarian by May 27. June 10 -11 4:30pm -11 am $40 /family West Park, 2700 W 116th Street NAY 16 1011 BY: 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. Tryon, TJ Terms 1118 Rutledge Ct Date Due Noblesville, IN 46062 Invoice invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 515/11 611512 Refund 37.08 Total 37.08 i 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, Tryon, TJ Allowed 20 1118 Rutledge Ct Noblesville, IN 46062 In Sum of 37.08 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1092 611512 4358400 37.08 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 19 -May 2011 i T Signature 37.08 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund