HomeMy WebLinkAbout199446 07/20/2011 CITY OF CARMEL, INDIANA VENDOR: 365481 Page 1 of 1
ONE CIVIC SQUARE PATRICIA FALIMIRSKI
CARMEL, INDIANA 46032 CHECK AMOUNT: $78.00
12431 BELLINGRATH ST
CARMEL IN 46032 CHECK NUMBER: 199446
CHECK DATE: 7/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 78.00 REFUND
ACTIVITY REFUND RECEIPT
Receipt 661461
Payment Date: 07/06/11
Household 1086
i!!,__ 0 7 2011
Monon Community Center Patricia Falimirski Hm Ph: (317)580 -1105
Carmel IN 46032 BY: 12431 Bellingrath St.
Carmel IN 46032 Cell Ph: (317)650 -5522
pfalgal@gmail.com
Phone: (317)848 -7275
Fed Tax 1D #35- 6000972
Enrollment Details
CANCELLATION Refund Of 78.00
Enrollee Name: Ethan Falimirski Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 116281 -02 Junior Golf 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 04/13/2011 (Cancelled)
Primary Instructor: Jim White
Class Location: West Park Field 3 Class Dates: 07/13/2011 to 08/03/2011
West Park 6:OOP to 7:OOP
2700 W. 116th St. W
Carmel IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/06/11 0 08:20:09 by LVA FEES CHANGED ON CANCELLED ITEMS 85.00
SURCHARGE APPLIED AGAINST CANCELLED FEES O 7.00
aNET- AMOUNT F,ROM�CANCELLEDsITEMS- c, "A 78
iTOTAL'AMOUNT .;REFUNDED-. 4 ay
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 78.00 Made By REFUND FINAN With Reference advanced request
All refunds are subject to State Board of Accounts claim procedure and may t 4 -6 wee s t rocess. A check will be
issue No cash or cr it card refunds.
Authorized S' ature to Au
ed Sig tur ate
Kids, get your parents to take you to our Touch a Truck event. There are a ton of amazing trucks and vehicles onsite for you to
explore. You can run around them, climb on them, and honk their horns. How cool is that This event is held rain or shine and
will take place on Wednesday, July 27 from 1 Oam -12pm at the Carmel High School Stadium (136th Street, west of Keystone).
The fee is $2/child and registration must be completed online at www.carmelclayparks.com prior to the event. It's a great
event;
you d not want to miss out!
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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.
Falimirski, Patricia Terms
12431 Bellingrath St Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/6/11 661461 Refund 78.00
Total 78.00
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.
Falimirski, Patricia Allowed 20
12431 Bellingrath St
Carmel, IN 46032
In Sum of
78.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -42 661461 4358400 78.00 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
13 -Jul 2011
IN�I l
Signature
78.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund