HomeMy WebLinkAbout212277 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 366498 Page 1 of 1
` ONE CIVIC SQUARE KRISTIN KIPP
'?. CARMEL, INDIANA 46032 15861 RIVER BIRCH ROAD CHECK AMOUNT: $35.00
WESTFIELD IN 46074 CHECK NUMBER: 212277
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4356400 35 . 00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 936833 Carmel ! lay
Payment Date: 08/17/2012
Household #: 36009 Parks&Recreation
Home Phone: (317)225-0351
Work Phone: (317) -
KRISTIN KIPP Morton Community Center
15861 RIVER BIRCH RD. Carmel IN 46032
WESTFIELD IN 46074 - g
Phone: (317)848-7275
AU G 21 2 112 Fed Tax ID #35-6000972
Enrollment Details
Enrollee Name: Kristin Kipp Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 127800-05 KidZone CPR/FA 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/17/2012 (Enrolled -Transfer from 127800-04 (Community CPR/FA))
Class Location: Pool Observation Rm Class Dates: 08/19/2012 to 08/19/2012
Monon Community Cntr 1:30P to 5:OOP
Su
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Special Questions: Check if this is a Guest Registration: No
Check if this is an Employee Registration: Yes
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/17/12 @ 10:08:39 by LVA FEES ADJUSTED ON CHANGED ITEMS(+) 35.00-
DISCOUNT APPLIED AGAINST THESE FEES() 0.00
NET FROM/TO TRANSFER TAX(+) 0.00
NET AMOUNT FROM CHANGED ITEMS 35.00-
TOTAL AMOUNT REFUNDED 35.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 35.00 Made By==>REFUND FINAN With Reference=_>
All ref4mlJp are subject to State Board of Accounts claim procedure and may t Zk - ee s to process. A check will be
4/Authorized o cash or credit ca refunds.
7 y Sign r Dat th ed Si ature ate
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Page# 1 of 2
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
Kipp, Kristin Date Due
15861 River Birch Rd.
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8117112 936833 Refund $ 35.00
Total $ 35.00
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
Kipp, Kristin
15861 River Birch Rd.
Westfield, IN 46074 In Sum of$
$ 35.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-10 936833 4358400 $ 35.00 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
23-Aug 2012
Signature
$ 35.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund