177282 09/15/2009 CITY OF CARMEL, INDIANA VENDOR: 363320 Page 1 of 1
ONE CIVIC SQUARE KELLY KETTERMAN CHECK AMOUNT: $62.50
CARMEL, INDIANA 46032 3413 EDEN HOLLOW
•,,_aM a� CARMEL IN 46033 CHECK NUMBER: 177282
CHECK DATE: 9/15/2009
D EPARTME NT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 333113 62.50 REFUNDS AWARDS INDE
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ACTIVITY REFUND RECEIPT
Receipt 333113
Payment Date: 09/03/2009
Household 1956
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process A cheA will be
issued. No cash or credit card refunds.
Aulhonzed Signature Dale Authorized Signature Date
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ACTIVITY REFUND RECEIPT
Receipt 333113
Payment Date: 09/03/2009
Household 1956
Home Phone: (317)846 -7745
Work Phone: (317)248 -4848
KELLY KETTERMAN Monon Center
3413 EDEN HOLLOW Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
ROSTER CHANGE Refund Of 62.50
Enrollee Name: Quinn Ketterman Fees Tax Discount Prey Paid Cur Paid Amount Due
Activity Number: 193023 -01 ARC Lifeguarding 62.50 0.00 62.50 0.00 0.00
Enrollment Date: 05/12/2009 (Enrolled)
Class Location: Indoor Lap Pool Class Dates: 05/11/2009 to 05/14/2009
Monon Center 9:00A to 5:00P
M,Tu,W,Th
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Fee Details: Fee_Description Amount Count Discount Sales Tax Total, Fee.
ARC Lifeguarding 62.50 1.00 0.00 0.00 62.50
G/L Code Description Account Csl,Cntr Description Account Number._ Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 62.50 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 09/03/09 14:54:50 by MCC FEES ADJUSTED ON CHANGED ITEMS 62.50
DISCOUNT APPLIED AGAINST THESE FEES 0.00
SALES TAX CHARGED ON CHANGED FEES 0.00
NET AMOUNT FROM CHANGED ITEMS
TOTAL AMOUNT REFUNDED 77TTO
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 62.50 Made By REFUND FINAN With Reference Red Cross completion
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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.
Ketterman, Kelly Terms
3413 Eden Hollow Date Due
Cannel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/3!09 333113 Refund 62.50
Total 62.50
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.
Ketterman, Kelly Allowed 20
3413 Eden Hollow
Carmel, IN 46033
In Sum of
62.50
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT XTITLE AMOUNT Board Members
Dept
1047 333113 4358400 62.50 1 hereby certify that the attached invoice(s), or
biii(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
10 -Sep 2009
Signature
62.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund