203823 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 00351341 Page 1 of 1
ONE CIVIC SQUARE JOE CUNNINGHAM
0 =1' CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 509 CONCORD LANE
o CARMEL IN 46032 CHECK NUMBER: 203823
CHECK DATE: 11/21/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 150.00 REFUND
PASS REFUND RECEIPT
Receipt 747521
Caret v Clay Payment Date: 11/11/11
rk &Recreation Household 16271
Monon Community Center Joe Cunningham Hm Ph: (317)846 -7624
Carmel IN 46032 509 Concord Lane
Carmel IN 46032 Cell Ph:
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 150.00
Pass Holder: Joe Cunningham Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Annual (M MCAA), #133088 270.00 0.00 0.00 270.00 0.00
Valid Dates: 03/21/2011 to 03/21/2012 (Pass Cancellation)
Cancel Reason: death of pass holder
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 11 /11 /11 18:14:34 by JLG FEES CHANGED ON CANCELLED ITEMS 420.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 270.00
NET AMOUNT FROM CANCELLED ITEMS 150.00
TOTAL AMOUNT REFUNDED 150.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 150.00 Made By REFUND FINAN With Referenc check refund
All refunds are subject to State Boar f Accounts claim procedure and may to weeks to process. A check will be
is No cash di r f ds.
11 W 1
Authorized Si ature Date th ign ure 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: /2011cprv.theregistrationsystem.com /en /1033!
NOV 1 5 2011 I�
Page 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.
Cunningham, Joe Terms
509 Concord Lane Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/11/11 747521 Refund 150.00
Total 150.00
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.
Cunningham, Joe Allowed 20
509 Concord Lane
Carmel, IN 46032
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 747521 4358400 150.00 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 2011
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
a