162327 08/07/2008 CITY OF CARMEL, INDIANA VENDOR: T361648 Page 1 of 1
ONE CIVIC SQUARE ROB FITZGERALD
CARMEL, INDIANA 46032 13477 VERSAILLES DR CHECK AMOUNT: $80.50
CARMEL IN 46032 CHECK NUMBER: 162327
CHECK DATE: 8/7/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4358400 80.50 PARKS DEPARTMENT REFU
i
i
ACTIVITY REFUND RECEIPT
Receipt 160501
RECEIVED
Payment Date: 07/24/2008 JUL 2 4 2008
Household 4025
Home Phone: (317)569 -0911
Work Phone: (317)837 -6801 $Y
ROB FITZGERALD Monon Center
13477 VERSAILLES DR Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 80.50
Enrollee Name: Brennen Fitzgerald Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 410005 -60 WC 10 20 Visit 34.50 0.00 34.50 0.00 0.00
Enrollment Date: 03/12/2008 (Cancelled)
Class Location: West Clay Elementary Class Dates: 08/14/2007 to 05/30/2008
West Clay Elementary 7:OOA to 6:OOP
3495 W. 126th St. M,Tu,W,Th,F
Carmel, IN 46032
(317)844 -9961 Scheduled Sessions: 200
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
WC 10 -Visit 34.50 1.00 0.00 0.00 34.50
Cancel Reason: had 7 remaining visit on 10 -punch card for ESE; changing schools from WC to SR, so will not
be utilizing the ESE program at SR
G/L Code De Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 80.50 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 07/24/08 11:09:11 by BJJ FEES CHANGED ON CANCELLED ITEMS 80.50
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
f SALES TAX CHARGED ON CANCELLED FEES 0.00
I
00 ,NETAMOUNT FROMI,CANCELLED ITEMS?^
4l� �N� TOTALAMOUNT= REFUNDED ,80.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 80.50 Made By REFUND FINAN With Reference
Page 1
g ACTIVITY REFUND RECEIPT
Receipt 160501
Payment Date: 07/24/08
Household 4025
=All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. cash or credit card refunds.
r6
t oriz ignature Date Authorized Signature Date
Page 2
r 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.
Fitzgerald, Rob Terms
13477 Versailles Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/24108 160501 Refund 80.50
Total 80.50
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.
Fitzgerald, Rob Allowed 20
13477 Versailles Dr
Carmel, IN 46032
In Sum of
80.50
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #(TITLE AMOUNT Board Members
Dept
1046 160501 4358400 80.50 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
28 -Jul 2008
Signature
80.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund