HomeMy WebLinkAbout211260 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 366428 Page 1 of 1
ONE CIVIC SQUARE KELLY DORIA CHECK AMOUNT: $285.00
0 ,CARMEL INDIANA 46032
13667 AMBLEWIND PLACE
WESTFIELD IN 46074 CHECK NUMBER: 211260
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 905755 285 . 00 REFUNDS AWARDS & INDE
PASS REFUND RECEIPT
Receipt# 905755
Car c I o Icy Payment Date: 07/18/12
ry Household #: 40001
arks& ecreedcan
Carmel Clay Parks & Recreation Kelly Doria Hm Ph: (317)873-1451
1235 Central Park Drive East 13667 Amblewind Place
Carmel IN 46032 Westfield IN 46074 Cell Ph:(317)491-3607
kellyadoria @gmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
MEMBERSHIP CHANGE - Refund Of 285.00
Pass Holder: Kelly Doria Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC HH Mthly (M MCHHM), #132048 760.00 0.00 760.00 0.00 0.00
Valid Dates: 03/07/2011 to 03/07/2012 (Pass Change)
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/18/12 @ 09:41:30 by ABK FEES ADJUSTED ON CHANGED ITEMS(+) 285.00-
NET AMOUNT FROM CHANGED ITEMS 285.00-
TOTAL AMOUNT REFUNDED 285.00 .
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 285.00 Made By==>REFUND FINAN With Reference==>3 mthly charges
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.
93 CP
Authorized ignat 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://2011cpry.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
Doria, Kelly Date Due
13667 Amblewind Place
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/18/12 905755 Refund $ 285.00
Total $ 285.00
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
Doria, Kelly
13667 Amblewind Place
Westfield, IN 46074 In Sum of$
$ 285.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 905755 4358400 $ 285.00 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
26-Jul 2012
Z211(:!k&mra,,h
Signature
$ 285.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund