174843 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 360698 Page 1 of 1
0 ONE CIVIC SQUARE MARK ENSOR CHECK AMOUNT: $110.47
CARMEL, INDIANA 46032 8901 ERINSBROOK DRIVE
RALEIGH NC 27617 CHECK NUMBER: 174843
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUM INVOICE NUMBER AMOU DESCRIPTION
1047 4358400 110.47 PARKS DEPARTMENT REFU H
PASS REFUND RECEIPT
Receipt 297998
Payment Date: 07/11/2009
Household 14178
Home Phone: (317)362 -3744
Work Phone:
MARK ENSOR Monon Center
1033 SEDONA PASS Carmel IN 46032
INDIANAPOLIS IN 46280 r'/'
r'>`'`,t� C. i ,'r,2 -c �'s.i C� f r t SG Phone: (317)848 -7275 n i=
Fed Tax ID #35- 6000972 1!
9( I I_ r r,5 b roc k' JUL 1 3 2009
(X,-- �iC f7 1f
Pass .Details
CANCELLATION Refund Of 110.47
Pass Holder: Mark Ensor Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #17705 129.53 0.00 129.53 0.00 0.00
Valid Dates: 12/2612008 to 12/26/2009 Pass Cancellation)
Fee Details: Fee_Description Amount Count Discount Sales Tax
Yearly Fitness Adult 129.53 1.00 0.00 0.00 129.53
Cancel Reason: Moving to N.C.
G /L Code. Description AccQUnt._Numbsr__,_____ Gt.Cntr__ Description AccountNumber.......____ Amount
999999 Control Account (AP) Enter Control Accl CNTRL Control Account (AP) Enter Control Acct here 110.47 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 07/11/09 14:54:41 by RDG FEES CHANGED ON CANCELLED ITEMS 110.47
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET:AMOUNT.FROM CANCELLED ITEMS; 110:47
TOTAL'AMOUNT.REFUNDED 110A7
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 110.47 Made By REFUND FINAN With Reference
All refunds are subject to�Slat� Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued sh or cre it card refund l
C
A
Authorized Signat re Date Authorized Signature Date
Li 7
Page 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.
Ensor, Mark Terms
8901 Erinsbrook Dr Date Due
Raleigh, NC 27617
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7111109 297998 Refund 110.47
Total 110.47
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.
Ensor, Mark Allowed 20
8901 Erinsbrook Dr
Raleigh, NC 27617
In Sum of
110.47
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept
1047 297998 4358400 110.47 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
16 -Jul 2009
Signature
110.47 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund