211511 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 364508 Page 1 of 1
ONE CIVIC SQUARE DAVID WANG CHECK AMOUNT: $212.50
CARMEL, INDIANA 46032 13144 HARRISON DRIVE
CARMEL IN 46033 CHECK NUMBER: 211511
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 903182 212 . 50 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 903182
sane i 19 Clay Payment Date: 07/16/12
#:
PaIrks&Recreation Household 33299
Morton Community Center David Wang Hm Ph: (317)846-4630
Carmel IN 46032 13144 Harrison Drive
Carmel IN 46033 Cell Ph:(317)414-9686
melingkuo @aol.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details r /I rg V10 G 'eAV `tl�
// �//y�' 7/)�✓ Oria Bal Refund New Bal
Module: Activity Registration r V V ! //li v v ' 212.50- 212.50 0.00
PREVIOUS NET HOUSEHOLD BALANCE 212.50
Processed on 07/16/12 @ 09:36:23 by JAB NEW REFUND AMOUNT(-) 212.50
Z I 4� .�- p/'1) TOTAL REFUNDABLE AMOUNT 212.50
Y `��%V7 4
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 212.50 Made By==>REFUND FINAN With Reference==>check refund
All refunds are subject to State Board of Accounts claim procedure and may take 4-6 weeks to process. A check will be
issu . No cash or credit card refunds.
07 U /IZ
orized Signature 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-.H2011 cpry.theregistrationsystem.com/en/1033!
DAY PASSES ARE NON-REFUNDABLE
RECFIVED
JUL 17 2012
BY:
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.
Wang, David Terms
13144 Harrison Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
$ 212.50
7116112 903182 Refund
Total $ 212.50
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.
Wang, David Allowed 20
13144 Harrison Drive
Carmel, IN 46033
In Sum of$
$ 212.50
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-1 903182 4358400 $ 212.50 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
$ 212.50 _ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund