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Home My WebLink About204794 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 365876 Page 1 of 1 ONE CIVIC SQUARE MARTHA FREEMAN CHECK AMOUNT: $156.00 CARMEL, INDIANA 46032 433 BRAESIDE DRIVE S INDIANAPOLIS IN 46260 CHECK NUMBER: 204794 CHECK DATE: 12/2012011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 156.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT Receipt 756287 a rf 1eI 1 8y Payment Date: 12/05/11 Household 4211 Perks &Recreafion Monon Community Center Martha Freeman Hm Ph: (317)815 -0842 Carmel IN 46032 433 Braeside Drive S Indianapolis IN 46260 Cell Ph: (317)696 -1539 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Refund Details, Oria Bal Refund New Bal Module: Activity Registration 34.00 34.00 0.00 PREVIOUS NET HOUSEHOLD BALANCE 34.00 Processed on 12/05/11 20:09:24 by JLG NEW REFUND AMOUNT 34.00 TOTAL REFUNDABLE AMOUNT 34.00 1 092, LIS /YM NEW NET HOUSEHOLD BALANCE 0.00 Refund of 34.00 Made By REFUND FINAN With Reference check refund All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 w o process. A check will be issued. No cash credit d r f ds. I Z 1 f I 12/7/111 uthorized 5 nature Date Authori ed ignature 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 httpsal2011 cpry .theregistrationsystem.com /en /l 033! 0 6 —1- Uk t (l� Itd r U k A h ul fl Page 1 of 1 PASS REFUND RECEIPT Receipt 756285 Care 16 1I Payment Date: 12/05/11 arksAecreation Household 4211 Monon Community Center Martha Freeman Hm Ph: (317)815 -0842 Carmel IN 46032 433 Braeside Drive S Indianapolis IN 46260 Cell Ph: (317)696-1539 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 104.00 Pass Holder: Martha Freeman Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: FIT Adlt Mnthly (XM FTAM), #46679 580.00 0.00 0.00 580.00 0.00 Valid Oates: 11/12/2009 to 01/1412012 (Pass Cancellation) Cancel Reason: moving (should have been cancelled 7125/ PREVIOUS NET CREDIT HOUSEHOLD BALANCE 52.00 Processed on 12/05/11 20:06:37 by JLG FEES CHANGED ON CANCELLED ITEMS 684.00 SURCHARGE APPLIED AGAINST CANCELLED FEES 580.00 NET AMOUNT FROM CANCELLED ITEMS 104.00 HH BALANCE APPLIED TO THIS RECEIPT 18.00 TOTAL AMOUNT REFUNDED 122.00 1091. y35_9y00 NEW NET CREDIT HOUSEHOLD BALANCE 34.00 Refund of 122.00 Made By REFUND FINAN With Reference check refund All refunds are sub'ect to to Board of Accounts claim procedure and may take 4- ks to process. A check will be issue o cas or e car re t n 17_ S I I 2 A thori7ed ature Date Authorize ignat r 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: /12011 cpry .theregistrationsystem.com /en /1033! 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. Freeman, Martha Terms 433 Braeside Drive S Date Due Indianapolis, IN 46260 Invoice Invoice Description Date Number (or note attached invoice(sror bill(s)) Amount 1215111 756287 Refund 34.00 1215/11 756285 Refund 122.00 Total 156.00 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 1 20 Clerk- Treasurer Voucher No. Warrant No, Freeman, Martha Allowed 20 433 Braeside Drive S Indianapolis, IN 46260 In Sum of 156.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1092 756287 4358400 34.00 1 hereby certify that the attached invoice(s), or 1092 756285 4358400 122.00 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 15 -Dec 2011 Signature 156.00 Accounts Payable Coordinator Cost distribution [edger classification if Title claim paid motor vehicle highway fund