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Home My WebLink About168360 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: T362467 Page 1 of 1 ONE CIVIC SQUARE PIERRE BERCLAZ CARMEL, INDIANA 46032 11349 ROYAL COURT CHECK AMOUNT: $180.00 Pq CARMEL IN 46032 CHECK NUMBER: 168360 IpN CHECK DATE: 2/4/2009 DEPARTMEN ACCOU PO NUM BER INVOICE NUMBER AMOU DE SCRIPTION 1047 4358400 180.00 PARKS DEPARTMENT REFU 4 ACTIVITY REFUND RECEIPT n.. Receipt 219911 Payment Date: 01/16/200 vZUUc� H' 4710 Home Phone: (317)843 -0007 Work Phone: (317)433 -8973 PIERRE BERCLAZ Monon Center 11349 ROYAL COURT Carmel IN 46032 CARMEL IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 180.00 Enrollee Name: Elise Berclaz Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 383015 -02 One -On -One Lessons 0.00 0.00 0.00 0.00 o.00 Enrollment Date: 02119/2008 (Cancelled) Primary Instructor: CCPR Staff Class Location: Pool Private Lesson2 Class Dates: 01/14/2008 to 08/20/2008 Monon Center 8:OOA to 7:OOP M,Tu,W,Th,F,Sa Carmel, IN 46032 (317)848 -7275 Scheduled Sessions: 189 Cancel Reason: The girls were unable fo finish the lessons and will not have time to compleete them G/L Code Description Accou Number Cst C ntr Descri Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 180,00 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 01/16/03 10:30:08 by ALC FEES CHANGED ON CANCELLED ITEMS 180.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 :'.NETAMOUNT FROM C 4NGELLED=ITEMS 70TAL' woo. t NEW NET HOUSEHOLD BALANCE 0.00 Refund of 180.00 Made By REFUND FINAN With Reference Page 1 ACTIVITY REFUND RECEIPT Receipt 219911 Payment Date: 01/16/2003 Household 4710 j All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issued. No cash or credit card refunds. Authorized S4& re Dat Authorized Signature Date Page 2 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. Berclaz, Pierre Terms 11349 Royal Court Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1116109 219911 Refund 180.00 Total 180.00 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. Berclaz, Pierre Allowed 20 11349 Royal Court Carmel, IN 46032 In Sum of$ 180.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 219911 4358400 180.00 1 hereby certify that the attached invoice(s), or bills) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 2 -Feb 2009 Signature 180.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund