HomeMy WebLinkAbout203282 11/17/2011 *,F CITY OF CARMEL, INDIANA VENDOR: 365733 Page 1 of 1
ONE CIVIC SQUARE ADRIANA HOWELL CHECK AMOUNT: $140.00
CARMEL, INDIANA 46032 815 GRACE DRIVE
CARMEL IN 46032
CHECK NUMBER: 203282
CHECK DATE: 11/712011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 140.00 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt 743192
Payment Date: 10/25/11
Household 26225
Monon Community Center (j C i 2011 Adriana Howell Hm Ph: (317)810 -9693
Carmel IN 46032 815 Grace Drive
Carmel IN 46032 Cell Ph:
adrianahowell@yahoo.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 76.00
Pass Molder: Adriana Howell Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: FIT Adlt Mnthly (XM I"TAM), #84129 508.00 0.00 0.00 508.00 0.00
!valid Dates: 1010812009 to 01114/2012 (Pass Cancellation)
Cancel Reason: moving. TDJ 10/24/11
The following item reflects a payment towards a previous receipt
Pass Holder: Bragan Howell Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type. Seas AQ Youth (SAQYR), #138391 60.00 0.00 0.00 60.00 0.00
Valid Dates: 05/28/2011 to 09/05/2011 (Pass Change)
Pass Comments: Children must be age 11 or older to utilize the pools and /or gymnasium unaccompanied by an adult.
The following item reflects a payment towards a previous receipt
Pass Holder: Adriana Howell Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Seas AQ Adutt (SAQAR), 9138390 55.00 0.00 81.00 4.00 0.00
Valid Dates, 05/28/2011 to 09105/2011 (Pass Change)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 10125111 09:19'.27 by TDJ FEES CHANGED ON CANCELLED ITEMS 848.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 508.00
NET AMOUNT FROM CANCELLED ITEMS 140.00
L'
C IL ]�1 FEES ADJUSTED ON CHANGED ITEMS 0.00
NET AMOUNT FROM CHANGED ITEMS 0.00
TOTAL AfAOYJNT REFUNDED 140.00
NEW NET HOUSEHOLD BALANCE D.DO
Refund of 140 -00 Made By REFUND FINAN With Reference
Payment of 64.00 Made By Pass Management Credit Balance
All refunds are subject to State Board of Accounts claim procedur tak 4- eks to pr ess. A check will be
issued. No Cash or credit card refunds.
4t f
brine g re Dat ized Signature Date
Page 1 of 2
l�
GLOBAL REFUND RECEIPT
Receipt 743192
Payment Date: 90/25/2011
Household 26225
Volunteer with Us!
Volunteers are the foundation of Carmel Clay Parks Recreation and we need your help! We are currently seeking volunteers
for special events, adaptive programs, parks and greenways, and Extended School Enrichment. If interested, please call Dana
at 317.843.3868 or register online at https: 11 2011cprv. theregistrationsystem .com /en110331
Page #E 2 of 2
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; k ind of service, of where
rice performed, dtes service rendered, by e.
whom, rates per day, number of hours rate r
Payee Purchase Order No.
Terms
howell, Adriana Date Due
815 Grace Drive
Carmel, IN 46032
Invoice Invoice
Description Amount
Date Number (or note attached invoice(s) or bill(s)) 140.00
10125111 743192 Refund
Total 140.00
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.
howell, Adriana Allowed 20
815 Grace Drive
Carmel, IN 46032
In Sum of
140.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 743192 4358400 140.00 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
3 -Nov 2011
Signature
140.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund