HomeMy WebLinkAbout210936 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 366419 Page 1 of 1
ONE CIVIC SQUARE CHRIS LOWE
s CHECK AMOUNT: $221.48
CARMEL, INDIANA 46032 1980E 110TH ST
INDIANAPOLIS IN 46280 CHECK NUMBER: 210936
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 878770 221 .48 REFUNDS AWARDS & INDE
PASS REFUND RECEIPT
Receipt# 878770
Carmel * Clay Payment Date: 07/01/12
J T'D Household #: 46039
Parks&Recreation
JUL 0 2 2012
Monon Community Center BY: Chris Lowe Hm Ph: (317)809-3161
Carmel IN 46032 1980 E. 110th Street
Indianapolis IN 46280 Cell Ph:
bdacamel @yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details �Rr ',61 e reas�� S
CANCELLATION -Refund Of 221.48
Pass Holder: Chris Lowe Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Annual (M MCAA),#157256 198.52 0.00 0.00 198.52 0.00
Valid Dates: 01/10/2012 to 01/10/2013 (Pass Cancellation)
Cancellation Effective: 07/01/2012
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/01/12 @ 10:29:00 by MJN FEES CHANGED ON CANCELLED ITEMS(+) 420.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 198.52-
1 NET AMOUNT FROM CANCELLED ITEMS 221.48-
� I TOTAL AMOUNT REFUNDED 221.48
+✓ ✓ V
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 221.48 Made By=_>REFUND FINAN With Reference==>me annual
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.
7 111 //Z i
Authorized Signature Date Au/tIbrizedlZonature 6a&
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
Date Due
Lowe, Chris
1980 E. 110th Street
Indianapolis, IN 46280
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
$ 221.48
7/1112 878770 Refund
Total $ 221.48
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
Lowe, Chris
1980 E. 110th Street
Indianapolis, IN 46280 In Sum of$
$ 221.48
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 878770 4358400 $ 221.48 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
12-Jul 2012
Signature
$ 221.48 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund