206181 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 366035 Page 1 of 1
ONE CIVIC SQUARE YAMEI CHEN
CARMEL, INDIANA 46032 644 CLEARVIEW DRIVE CHECK AMOUNT: $55.00
CARMEL IN 46033 CHECK NUMBER: 206181
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 55.00 PARKS DEPARTMENT REFU
i
PASS REFUND RECEIPT
Receipt 781150
Carmel 1D Cla Payment Date: 02/02/12
Household ousehold 1989
Monon Community Center Yamei Chen Hm Ph: (317)571 -0588
Carmel IN 46032 6044 Clearview Drive Wk Ph: (317)651 -2675
Carmel IN 46033 Cell Ph: (317)985 -5720
Phone: (317)848 -7275 yameichen99Qhotmail.com
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 55.00
Pass Holder: Parker JOu Fees Tax Discount Prey Paid Cur Paid Amount Due
Pass Type: 20 -Visit (ESE20V), #42102 165.00 0.00 165.00 0.00 0.00
Valid Dates: 09/20/2011 to 05/27/ (Pass Cancellation)
Cancel Reason: no longer uses program; will be in 6th grade next year V C U V
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 02/02/12 08:34:19 by JAB FEES
/I FEES CHANGED ON CANCELLED ITEMS 55.00
fit' U y� V NET AMOUNT FROM CANCELLED ITEMS 55.00
JJJ V I TOTAL AMOUNT REFUNDED 55.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 55.00 Made By REFUND FINAN With Reference check refund
All r nds are /orc Boar nto>�s claim procedure and may take 4 -6 weeks to process. A check will be
i s o cait card ref unds.
Authorized ignature Date Authorized Signature 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: //2011 cpry .theregistrationsystem.com /en /1033!
FEB 0 2 2012
Page 1 of
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.
Chen, Yamei Terms
6044 Clearview Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/2/12 781150 Refund 55.00
Total 55.00
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.
Chen, Yamei Allowed 20
6044 Clearview Drive
Carmel, IN 46033
In Sum of
55.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -11 781150 4358400 55.00 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
9 -Feb 2012
Signature
55.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund