HomeMy WebLinkAbout203283 11/17/2011 CITY OF CARMEL, INDIANA VENDOR: 365734 Page 1 of 1
ONE CIVIC SQUARE STEVEN KIRSH
CARMEL, INDIANA 46032 1332ND ST NW CHECK AMOUNT: $62.78
CARMEL IN 46032 CHECK NUMBER: 203283
CHECK DATE: 11/7/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 62.78 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt 743248
Payment Date_ 10!25/11
Household 4635
Monon Community Center Steven Kirsh Hm Ph: (317)848 -9994
Carmel IN 46032 133 2nd St NW Wk Ph: (317)575 -5555
Carmel IN 46032 Cell Ph: (317)443 -4343
Steve @kirsh.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Locker Registration Details:
CANCELLATION Refund Of 62.78
Member Name: Steven Kirsh P Tax isc ini Prev Paid Cur ✓'ail Amount Due
Locker Room: Fitness Center Men's 11722 0.00 117.22 0.00 0.00
Locker Number: 75
Valid Dales: 03101 033/01112
Cancel Reason: can pass
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 10/25/11 12:33:30 by TLP FEES CHANGED ON CANCELLED ITEMS 62.78
NET'a'AMOUNYF.ROMi ITEMS.'; 62 78
����p .TOTAL?`p:MOUNT`REF.UNDED
f k:� 3 NEW NET HOUSEHOLD BALANCE 0.00
Refund of 62.78 Made B FINAN With Reference
All refunds are subject t Accounts claim procedure and may to e 4 -6 vyeeks to process. A check will be
issued. ash or cre it a
Authorized Signa re Date Authanzed 19nature Date
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:/ 12011cpry .theregistrationsystem.com /en /l 0331
OCT 2 8 2011
Page 4 1 of 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.
Kirsh, Steven Terms
133 2nd ST NW Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/25/11 743248 Refund 62.78
Total 62.78
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Kirsh, Steven Allowed 20
133 2nd ST NW
Carmel, IN 46032
In Sum of
62.78
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #(TITLE AMOUNT Board Members
Dept ept
1096 -21 743248 4358400 62.78 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
a""-JA I/
Signature
62.78 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund