211301 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 366430 Page 1 of 1
�I. ONE CIVIC SQUARE CLARENCE GUESS CHECK AMOUNT: $15.00
CARMEL, INDIANA 46032 14438 EQUALITY BLVD,1A
o�co CARMEL IN 46033 CHECK NUMBER: 211301
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 893875 15 . 00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 893875
Carmel * Clay Payment Date: 07/11/12
Household #: 45697
Parks&Recreation
Monon Community Center Clarence Guess Hm Ph: (317)853-6617
Carmel IN 46032 14438 Equality Blvd, 1A Wk Ph: (443)695-1481
Carmel IN 46033 Cell Ph:(443)695-3906
cguess2 @live.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 15.00
Enrollee Name: Elijah Guess Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 128001-02 Parents Night Out 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/02/2012 (Cancelled)
Class Location: Multi-Purpose Room Class Dates: 07/14/2012 to 07/14/2012
Monon Community Cntr 5:30P to 8:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/11/12 @ 14:22:27 by BNT FEES CHANGED ON CANCELLED ITEMS(+) 15.00-
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 15.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 15.00 Made By==>REFUND FINAN With Reference==>low enrollment
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 cr dit card refunds.
�.o I - I -IZ_ --.- -11111(
Authorized Signature Date Authorized Signature Date
I IMF � -L(;,s fm
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://201 lcprv.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
Guess, Clarence Date Due
14438 Equality Blvd., 1A
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/11/12 893875 Refund $ 15.00
Total $ 15.00
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
Guess, Clarence
14438 Equality Blvd., 1A
Carmel, IN 46033 In Sum of$
$ 15.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-70 893875 4358400 $ 15.00 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
Signature
$ 15.00 _ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund