158144 04/01/2008 CITY OF CARMEL, INDIANA VENDOR: T361080 Page 1 of 1
ONE CIVIC SQUARE KEN SULLIVAN
CARMEL, INDIANA 46032 9844 CHAMBRAY DR CHECK AMOUNT: $6.75
INDPLS IN 46280
CHECK NUMBER: 158144
CHECK DATE: 4/1/2008
DEPARTMENT ACCOUNT PO NU MBER IN VOIC E NUMBER AMOUNT DESC RIPTION
1047 4358400 100057 6.75 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 100057
Paym I nt Date: 03/13/2008
Household 16472
Home Phone: (317)843 -1170 CIEAVE
Work Phone:
MAR 1 7 2008
BY:
KEN SULLIVAN Monon Center
9844 CHAMBRAY DRIVE Carmel IN 46032
INDIANAPOLIS, IN 46280
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
ROSTER CHANGE Refund Of 6.75
Enrollee Name: Ken Sullivan Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 384502 -07 Aqua Blast 20.25 0.00 20.25 0.00 0.00
Enrollment Date: 03/03/2008 (Enrolled)
Primary Instructor: CCPR Staff
Class Location: Indoor Lap Pool 1 Class Dates: 03/05/2008 to 03/26/2008
Monon Center 6:OOP to 6:50P
Carmel, IN 46032 W
(317)848 -7275 Scheduled Sessions: 4
Fee Details: Fee Description Amount Count Di scount Sales Tax Total Fee
Aqua Blast Resident 20.25 1.00 0.00
0.00 20.25
G/L Code Description Account Number Cst Cntr Description Account Number Amoun
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 6.75 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 03/13/08 15:11:22 by CEK FEES ADJUSTED ON CHANGED ITEMS 6.75
DISCOUNT APPLIED AGAINST THESE FEES 0.00
SALES TAX CHARGED ON CHANGED FEES 0.00
NET AMOUNT FROM "CHANGED1TEMS 6.75=
TOTAL AMOUNT REFUNDED 6:75'
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance
Page 1
ACTIVITY REFUND RECEIPT
Receipt 100057
Payment Date: 03/13/08
Household 16472
Refund of 6.75 Made By JOURNAL RF With Reference instructor illness
All refunds are subject to State Board of Accounts claim procedure and may to a 4 -6 w ks to process. A check will be
issued. No cash or credit card refunds.
2L 3 a
Authorized Signature j 1 Date Aut orized Si at Dat
Z -A C3, WO I M2�
Page 2
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.
Ken Sullivan Terms
9844 Chambray Dr. Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/13/08 100057 Refund 6.75
Total 6.75
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.
Ken Sullivan Allowed 20
9844 Chambray Dr.
Indianapolis, IN 46280
In Sum of
6.75
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1047 100057 4358400 6.75 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
24 -Mar 2008
Signature
6.75 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund