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Home My WebLink About166210 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: T362180 P89@ 1 of 1 ONE CIVIC SQUARE MARK FUGATE CHECK AMOUNT: $84.00 CARMEL, INDIANA 46032 86 HAWTHORNE DR CARMEL IN 46033 CHECK NUMBER: 166210 CHECK DATE: 11/2412008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 199775 84.00 REFUNDS AWARDS INDE i i ACTIVITY REFUND RECEIPT Receipt 199775 Payment Date: 11/07/2008 Household 13091 Home Phone: (317)574 -9561 1N'ork Phone: (317)285 -4057 NOV 1 2 2008 BY: MARK FUGATE Monon Center 86 HAWTHORNE DRIVE Carmel IN 46032 CARMEL IN 46033 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 i Enrollment Details CANCELLATION Refund Of 42.00 Enrollee Name: Lydia Fugate Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 286362 -04 Basic Self Defense f 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 08/10/2008 (Cancelled) Primary Instructor: House of Martial Arts Class Location: Fitness Studio B Class Dates: 11/06/2008 to 12/18/2008 Monon Center 4:OOP to 5:OOP Th Carmel, IN 46032 Skip Days 11/27/2008 (317)848 -7275 Scheduled Sessions: 6 Cancel Reason: low enrollment CANCELLATION Refund Of 42.00 Enrollee Name: Graham Fugate Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 286362 -04 Basic Self Defense f 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 08/10/2008 (Cancelled) Primary Instructor: House of Martial Arts Class Location: Fitness Studio B Class Dates: 11/06/2008 to 12/18/2008 Monon Center 4 :OOP to 5:OOP Th Carmel, IN 46032 Skip Days 11/27/2008 (317)848 -7275 Scheduled Sessions: 6 Cancel Reason: low enrollment G/L Code Descri Account Num ber______ Cst Cntr Descri Account Nu mber_ Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 84.00 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. Page 1 ACTIVITY REFUND RECEIPT Receipt 199775 Payment Date: 11/07/2008 Household 13091 PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 11/07/08 11:36:54 by LVA FEES CHANGED ON CANCELLED ITEMS 84.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS TOTAL AMOUNT AMOUNT REFUNDED 84.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 84.00 Made By REFUND FINAN With Reference low enrollment 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. ALaQAn Authorized i nature Date Authorized Signature Date L17 '3 W. �00. S SG 1�et1 c Low -en rol I wvvi Page 2 I 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. Fugate, Mark Terms 86 Hawthorne Drive Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached. invoice(s) or bill(s)) Amount 11/7/08 199775 Refund 84.00 Total 84.00 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. Fugate, Mark Allowed 20 86 Hawthorne Drive Carmel, IN 46033 In Sum of 84.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 199775 4358400 84.00 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 K-Z /h Z= 2 Signature 84.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund