HomeMy WebLinkAbout201041 08/30/2011 CITY OF CARMEL, INDIANA VENDOR: 365642 Page 1 of 1
ONE CIVIC SQUARE THOMAS VALEK
CARMEL, INDIANA 46032 14703 MACDUFF DR CHECK AMOUNT: $35.00
NOBLESVILLE IN 46062 CHECK NUMBER: 201041
CHECK DATE: 8/30/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 35.00 REFUND
ACTIVITY REFUND RECEIPT
Receipt 715985
Payment Date: 08/17/11
Household 34160
Monon Community Center Thomas Valek Hm Ph: (248)404 -8222
Carmel IN 46032 14703 Macduff Drive
Noblesville IN 46062 Cell Ph:
Phone: (317)848 -7275 tvalek @me.com,tvalek @me.net
Fed Tax ID #35- 6000972
Enrollment Details
ROSTER CHANGE Refund Of 14.00
Enrollee Name: Carrie Valek Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 114201 -07 Zumba 21.00 0.00 21.00 0.00 0.00
Enrollment Date: 07/25/2011 (Enrolled)
Class Location: Dance Studio Class Dates: 08/01/2011 to 08/29/2011
Monon Community Cntr M :OOP to 7:50P
Carmel, IN 46032 Scheduled Sessions: 5 �t AUG 1� n
(317)848 -7275 2 2 2011
a
ROSTER CHANGE Refund Of 21.00
Enrollee Name: Carrie Valek Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 114201 -08 Zumba 14.00 0.00 14.00 0.00 0.00
Enrollment Date: 07/25/2011 (Enrolled)
Class Location: Dance Studio Class Dates: 08/03/2011 to 08/31/2011
Monon Community Cntr 7:OOP to 7:50P
W
Carmel, IN 46032 Scheduled Sessions: 5
(317)848 -7275
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/17/11 14:09:55 by LWW FEES ADJUSTED ON CHANGED ITEMS 35.00
NET AMOUNT FROM CHANGED ITEMS 35.00
TOTAL AMOUNT REFUNDED 35.00
V
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 35.00 Made By REFUND FINAN With Reference Check refund
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. cash or credit card refunds.
Authorized Signature Date Authorized Signature Date
10 1W•��.�c.J�$�Ol./ 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.
Valek, Thomas Terms
14703 Macduff Drive Date Due
Noblesville, IN 46062
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
8117111 715985 Refund 35.00
Total 35.00
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.
Valek, Thomas Allowed 20
14703 Macduff Drive
Noblesville, IN 46062
In Sum of
35.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 715985 4358400 35.00 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
26 -Aug 2011
14filarim�
Signature
35.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund