210890 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 366416 Page 1 of 1
0 ONE CIVIC SQUARE KELLY HINDMAN CHECK AMOUNT: $148.00
CARMEL, INDIANA 46032 13852 SILVER STREAM DRIVE
CARMEL IN 46032 CHECK NUMBER: 210890
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 891905 148 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Car Clay Receipt# 891905
Payment Date: 07/10/12
Parks&Recreation Household#: 26738
Monon Community Center Kelly Hindman Hm Ph: (317)848-7177
Carmel IN 46032 JUL C 1 2012 13852 13852 Silver Stream Drive Wk Ph: (317)843-2455
I Carmel IN 46032 Cell Ph:(317)698-5218
kelly.hind man @edwardjones.com,kch311 @aol.com,hindmanmoney(c
Phone: (317)848-7275 �e=r':`°':
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 148.00- 148.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 148.00
Processed on 07/10/12 @ 10:03:02 by KLB NEW REFUND AMOUNT(-) 148.00
TOTAL REFUNDABLE'AMOUNT ' `148.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 148.00 Made By==>REFUND FINAN With Reference==>cancelled class
All refunds are subject to State Board of Accounts claim procedure and m 4 6 eeks to process. A check will be
issued. No cash or credit card refunds. X
l0/1 Z
Authorized Signature Date u orized S' ure 6ate
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
Page# 1 of 1
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
Hindman, Kelly Date Due
13852 Silver Stream Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/1/12 891905 Refund
$ 148.00
Total $ 148.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Allowed 20
Hindman, Kelly
13852 Silver Stream Drive
Carmel, IN 46032 In Sum of$
$ 148.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
i
1096-50 891905 4358400 $ 148.00 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
i
12-Jul 2012
Signature
$ 148.00 _ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund