HomeMy WebLinkAbout210558 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 366328 Page 1 of 1
ONE CIVIC SQUARE RANDALL STIMAC
CARMEL, INDIANA 46032 4625 BUCKINGHAM COURT CHECK AMOUNT: $20.00
CARMEL IN 46033
CHECK NUMBER: 210558
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 20.00 PARKS DEPARTMENT REFU
LOCKER REFUND RECEIPT
Receipt# 828006
Car Payment Date: 05/18/12
Household 4937
Fear s &f-e reati
Monon Community Center Randall Stimac Hm Ph: (317)844 -6215
Carmel IN 46032 4625 Buckingham Court Wk Ph: (317)571 -8931
Carmel IN 46033 Cell Ph: (317)679-7526
rstimac@ aol .com,danielle.stimac @gmail.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Locker Registration Details:
RESERVATION CHANGE Refund Of 10.00
Member Name: Randall Stimac Fees Tax Discount Prev Paid Cur Paid Amount Due
Locker Room: Fitness Center Men 35.00 0.00 35.00 0.00 0.00
Locker Number: 84
Valid Dates: 03/01/12 to 02/28/13 New Registration)
RESERVATION CHANGE Refund Of 10.00
Member Name: Diane Stimac Fees Tax Discount Prev Paid Cur Paid Amount Due
Locker Room: Fitness Center Women 35.00 0.00 35.00 0.00 0.00
Locker Number: 97
Valid Dates: 03/01/12 to 02/28/13 New Registration)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 05/18/12 10:52:17 by LWW FEES ADJUSTED ON CHANGED ITEMS 20.00
NET AMOUNT FROM.`CHANGED ITEMS, 20.00
TOTAL AMOUNT REFUNDECr 20.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 20.00 Made By REFUND FINAN With Reference Check refund
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 w ks to rocess. A check will be
issued. No cash or credit card refunds.
Authorized Signature Date Auth ize Sign tur Dad
i 0 q .0 2) to CU U I O S C: I
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 cprv. 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
Stimac, Randall Date Due
4625 Buckingham Court
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/18/12 828006 Refund 20.00
Total 20.00
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.
Allowed 20
Stimac, Randall
4625 Buckingham Court
Carmel, IN 46033 In Sum of
20.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -21 828006 4358400 20.00 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
28 -Jun 2012
�JQU m
Signature
20.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund