HomeMy WebLinkAbout209749 06/18/2012 CITY OF CARMEL, INDIANA VENDOR: 366303 Page 1 of 1
ONE CIVIC SQUARE GERRY BUSH CHECK AMOUNT: $78.00
CARMEL, INDIANA 46032 501 SONHATSETT DRIVE
WESTFIELD IN 46074 CHECK NUMBER: 209749
CHECK DATE: 6/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 78.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 849861
Carmel o Cl Payment Date: 06/13/12
TRF- FT 7 D Household 42793
r� i�� r tin
JUN 15 2012
Monon Community Center ��z,. Gerry Bush Hm Ph: (317)867 -1094
Carmel IN 46032 501 Sonhatsett Dr
Westfield IN 46074 Cell Ph:(317)650 -8851
Phone: (317)848 -7275 bushc@ wws. k12. in. us ,bcbush @spartansmanchester.edu
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 78.00
Enrollee Name: Brittanl Bush Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 123020 -01 WSI 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 05/24/2012 (Cancelled)
Class Location: Pool Observation Rm Class Dates: 06/12/2012 to 06/15/2012
Monon Community Cntr 9:00A to 6-OOP
TU,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: could not attend class
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/13/12 14:33:13 by NMH FEES CHANGED ON CANCELLED ITEMS 85.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUNT FROM CANCELLED ITEMS 78.00.
TOTAL AMOUNT REFUNDED 78.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 78.00 Made By REFUND FINAN With Reference Refund Check
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to procass. A check viii be
issued. No cash or credit card refunds.
Authorized Signature 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!
DAY PASSES ARE NON REFUNDABLE
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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.
Terms
Bush, Gerry Date Due
501 Sonhatsett Dr
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/13/12 849861 Refund 78.00
Total 78.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Allowed 20
Bush, Gerry
501 Sonhatsett Dr
Westfield, IN 46074 In Sum of
78.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -10 849861 4358400 78.00 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
14 -Jun 2012
Signature
78.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund