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166134 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: T362176 Page 1 of 1 ONE CIVIC SQUARE KAREN BOWER i. CARMEL, INDIANA 46032 1785 PINE VALLEY DR CHECK AMOUNT: $256.00 CARMEL IN 46032 CHECK NUMBER: 166134 CHECK DATE: 11/24/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION 1047 4358400 197532 256.00 REFUNDS AWARDS INDE �r ACTIVITY REFUND RECEIPT g Receipt 197532 2�0$ Payment Date: 10/29/2008 NOV 1 2 Household 21924 Rune Phone: (317)575 -9017 3y. Work Phone: (317) KAREN BOWER Monon Center 1785 PIINE VALLEY DRIVE Carmel IN 46032 CARMEL IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 121.00 Enrollee Name: Karen Bower Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 287335 -02 Dancing as the Stars 7.00 0.00 0.00 7.00 0.00 Enrollment Date: 09/02/2008 (Cancelled) Primary Instructor: Int Talent Academy Class Location: Dance Studio Class Dates: 10/29/2008 to 12/17/2008 Monon Center 8:OOP to 9:OOP W Carmel, IN 46032 Skip Days 11/26/2008 (317)848 -7275 Scheduled Sessions: 7 Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee Dancing Workout Resi 7.00 1.00 0.00 0.00 7.00 Cancel Reason: medical -injury CANCELLATION Refund Of 135.00 Enrollee Name: Steve Housefield Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 287335 -02 Dancing as the Stars 7.00 0.00 0.00 7.00 0.00 Enrollment Date: 09102/2008 (Cancelled) Primary Instructor: Int Talent Academy Class Location: Dance Studio Class Dates: 10/29/2008 to 12/17/2008 Monon Center 8:OOP to 9:OOP W Carmel, IN 46032 Skip Days 11/26/2008 (317)848 -7275 Scheduled Sessions: 7 Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee Dancing Workout Resi 7.00 1.00 0.00 0.00 7.00 Cancel Reason: medical -injury Page 1 ACTIVITY REFUND RECEIPT Receipt 197532 Payment Date: 10/29/2008 Household 21924 G /L Code Description _Ac count Number Cst Cntr Descriptio Account Number Am ount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 256.00 DR The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund. Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers. PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 10/29/08 08:09:54 by MML FEES CHANGED ON CANCELLED ITEMS 270.00 DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 SURCHARGE APPLIED AGAINST CANCELLED FEES O 14.00 NET AMOUNT FROM CANCELLED ITEMS 256.00 TOTAL AMOUNT REFUNDED. 256.00' NEW NET HOUSEHOLD BALANCE 0.00 Refund of 256.00 Made By REFUND FINAN With Reference injury Rewards Points refunded on this receipt: 1.40 Household Reward Point Balance: 33.00 All refunds a ub'ect Boar f Accounts claim procedure and may take 4 -6 weeks to process. A check will be issued c c I car refu s. Au o ed Signature ate Authorized Signature Date 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. Bower, Karen Terms 1785 Pine Valley Drive Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/29/08 197532 Refund 256.00 Total 266.00 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. Bower, Karen Allowed 20 1785 Pine Valley Drive Carmel, IN 46032 I n Sum of 256.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TlTLE AMOUNT Board Members Dept 1047 197532 4358400 256.00 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 17 -Nov 2008 �ILI 2 Signature 256.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund