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Home My WebLink About176917 09/02/2009 CITY OF CARMEL INDIANA VENDOR: 363292 Page 1 of 1 ONE CIVIC SQUARE LORY RODRIGUEZ e CARMEL, INDIANA 46032 2989 VININGS DRIVE CHECK AMOUNT: $300.00 CARMEL IN 46032 CHECK NUMBER: 176917 CHECK DATE: 9/2/2009 D EPARTMENT ACCOUNT PO NUMBER INVOICE N AMOUNT DESCRIPTION 1046 4358400 300.00 PARKS DEPARTMENT REFU 'r f'� 4 ACTIVITY REFUND RECEIPT Receipt 322687 Payment Date: 08/11/2009 Household 12596 Home Phone: (317)810 0930( Work Phone: (317)510 -4604 LORY RODRIGUEZ Monon Center 2989 VININGS DR. Carmel IN 46032 4 CARMEL IN 46032 Phone: (317)848-7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 150.00 Enrollee Name: Lorraine Rodriguez Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -18 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 05/08/2009 (Cancelled) Class Location: Forest Dale Elem Class Dates: 07/20/2009 to 07/24/2009 Forest Dale Elementa 7:OOA to 6:OOP 10721 Lakeshore Dr. West M,Tu,W,Th,F Carmel, IN 46033 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: suspended from fdvs (for weeks 8 9) CANCELLATION Refund Of 150.00 Enrollee Name: Lorraine Rodriguez Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -19 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 05108/2009 (Cancelled) Class Location: Forest Dale Elem Class Dates: 07/27/2009 to 07/31/2009 Forest Dale Elementa 7:OOA to 6:OOP 10721 Lakeshore Dr. West M,Tu,W,Th,F Carmel, IN 46033 Scheduled Sessions: 5 (317)848 -7275 cancel Reason: suspended from fdvs (for weeks 8 9) G/L Code Description Account Number Cst Cntr Description Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 300.00 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. Page 1 ACTIVITY REFUND RECEIPT Receipt 322687 Payment Date: 08/11/2009 Household 12596 PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 08/11/09 09:41:04 by BJJ FEES CHANGED ON CANCELLED ITEMS 300.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM "CANCELLED,JT:EMS" 300.00 TOTAL AMOUNT'REFUNDEI)` "i... 300;00,= NEW NET HOUSEHOLD BALANCE 0.00 Refund of 300.00 Made By REFUND FINAN With Reference All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issued. N cash or credit card refunds. e/I A tho d Signature Date Authorized Signature Date 3-r),-q a° t b 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. Rodriguez, Lory Terms 2989 Vinings Dr Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8/11/09 322687 Refund 300.00 Total 300.00 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. Rodriguez, Lory Allowed 20 2989 Vinings Dr Carmel, IN 46032 In Sum of 300.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITL AMOUNT Board Members Dept 1046 322687 4358400 300.00 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 27 -Aug 2009 xul"1m�Z4 Signature 300.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund