206724 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 366054 Page 1 of 1
ONE CIVIC SQUARE ALLAN KARLANDER
CARMEL, INDIANA 46032 4940 DEER RIDGE DR N CHECK AMOUNT: $15.00
a;.pod.�u CARMEL IN 46033 CHECK NUMBER: 206724
CHECK DATE: 2/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 15.00 PARKS DEPARTMENT REFU
LOCKER REFUND RECEIPT
Receipt 786117
C arm el rme a Clay Payment Date: 02/15/12
J sreation Household 5740
Monon Community Center Allan Karlander Hm Ph: (317)571 -8128
Carmel IN 46032 4940 Deer Ridge Dr. N.
P FEB 16 1012 Carmel IN 46033 Cell Ph: (317)443-0705
Phone: (317)848 -7275 alkarlander @sbcglobal.net
Fed Tax ID #35- 6000972 BY.
Locker Registration Details:
RESERVATION CHANGE Refund Of 15.00
Member Name: Allan Karlander Fees Tax Discount Prev Paid Cur Paid Amount Due
Locker Room: Fitness Center Men's 165.00 0.00 165.00 0.00 0.00
Locker Number: 82
Valid Dates: 03/01/11 to 03/01/12 New Registration)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 02/15/12 09:25:01 by LWW FEES ADJUSTED ON CHANGED ITEMS 15.00
NET AMOUNT FROM CHANGED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 15.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 15.00 Made By REFUND FINAN With Reference Check refund
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
2.1 s.l2
Authorized Signature Date Aut o.ized ignature Date
10919.21. (O OO 10 .0 iSC.
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!
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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,
Karlander, Allan Terms
4940 Deer Ridge Dr. N. Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2115/12 786117 Refund 15.00
Total 15.00
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.
Karlander, Allan Allowed 20
4940 Deer Ridge Dr. N.
Carmel, IN 46033
In Sum of
15.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1096 -21 786117 4358400 15.00 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
23 -Feb 2012
Signature
15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund