HomeMy WebLinkAbout199545 07/20/2011 CITY OF CARMEL, INDIANA VENDOR: 365485 Page 1 of 1
ONE CIVIC SQUARE LORI JUSTIN
CARMEL, INDIANA 46032 3770 CANTERBURY COURT CHECK AMOUNT: $53.50
CARMEL IN 46033 CHECK NUMBER: 199545
CHECK DATE: 7/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4358400 53.50 REFUNDS AWARDS INDE
FACILITY REFUND RECEIPT
Receipt 670919
Payment Date: 07/12/11
Household 41941
I
Monon Community Center c4 Lori Justin Hm Ph: (317)815 -5545
Carmel IN 46032 �ttE. 1 4 201 IY 3770 Canterbury Court
Carmel IN 46033 Cell Ph:
lori.justin @gmail.com
Phone: (317)848 -7275 BY:
Fed Tax ID #35- 6000972
Facility Reservation Details
CANCELLATION Refund Of 53.50
Facility: Inlow Park, Inlow South Shelter
Reserv. Number: 17977 Status: Cancelled
Purpose: Birthday Party
Anticipated Count: 28
Date Day Time Fees Tax Discount Prev Paid Cur Paid Amount Due
07/02/2011 Sat 1:OOP to 3:OOP 0.00 0.00 0.00 0.00 0.00
Cancel Reason: unhappy guest
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/12/11 15:53:58 by MCC FEES CHANGED ON CANCELLED ITEMS 50.00
q SALES TAX CHARGED ON CANCELLED FEES 3.50
b t�✓ 3 Q 1 NET AMOUNT FROM CANCELLED ITEMS 53.50-
GL
1 TOTAL AMOUNT REFUNDED 53.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 53.50 Made By REFUND FINAN With Reference staff error /correct
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.
The count for this line item will not be known until after the reservation date. Therefore, both the count and the extension are
left at zero for reservation purposes, but will be updated after the reservation date. As soon as this data is available, you will
be invoiced for the current amount due. Please remit to our office within 10 days of the invoice date.
4�A_j
Authorized Signatu a Date Authorized Signature Date
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 10am -12pm at the Carmel High School Stadium (136th Street, west of Keystone).
The fee is $2 1child and registration must be completed online at www.carmelclayparks.com prior to the event. It's a great
event; you do not want to miss out!
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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.
Justin, Lori Terms
3770 Canterbury Court Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7112111 670919 Refund 53.50
Total 53.50
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Justin, Lori Allowed 20
3770 Canterbury Court
Carmel, IN 46033
In Sum of
53.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1095 -3 670919 4358400 53.50 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
Signature
53.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund