HomeMy WebLinkAbout213091 09/25/2012 ate. CITY OF CARMEL, INDIANA VENDOR: 366552 Page 1 of 1
ONE CIVIC SQUARE TAMISA LUSH CHECK AMOUNT: $74.00
=f r CARMEL, INDIANA 46032 4868 ASHBROOK DR
•w oN�; NOBLESVILLE IN 46062 CHECK NUMBER: 213091
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 74 . 00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Carmel Clay Receipt# 951716
* Clay Date: 09/17/12
Pa Recreation Household #: 49536
R-1 F. � .s'7T1-7f ��
j I CiiM�SC. Lv S�
Monon Community Center S E P 1 9 2012 �— Hm Ph: (317)
Carmel IN 46032 4868 Ashbrook Drive
Y. Noblesville IN 46062 Cell Ph:
1y.
Phone: (317)848-7275 — - - ——J
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 74.00
Enrollee Name: Joseph Rush Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 226117-02 Hip Hop 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/03/2012 (Cancelled)
Primary Instructor: Dance Class Studio
Class Location: Dance Studio B Class Dates: 09/08/2012 to 11/17/2012
Monon Community Cntr 12:15P to 12:45P
Sa
Carmel, IN 46032 Scheduled Sessions: 11
(317)848-7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/17/12 @ 12:59:12 by LVA FEES CHANGED ON CANCELLED ITEMS(+) 74.00-
NET AMOUNT FROM CANCELLED ITEMS 74.00-
TOTAL AMOUNT REFUNDED 74.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 74.00 Made By==>REFUND FINAN With Reference==>advanced request
All refunds are subject to State Board of Accounts claim procedure and may take 4-6 weeks to process. A check will be
issue . o cash or credit card r nds.
Cl (71 I
Authorized Signature V Date Authori� d Sign at Date
Join us for Tour de Carmel
Bike along with us on Saturday, September 15, as we highlight some of the best parks, businesses, and entertainment Carmel
has to offer. This is a safe and family friendly event that allows you to create lasting memories while promoting fitness. From
training wheels to pedal clips, we have a route for you! Don't want to ride? Come volunteer with us! For more information visit
www.carmelclayparks.com.
( 0Q �p - 14D- --'4 31 �9 -1 COQ
HWA C-a-0 V--o-qu-e---)T
`� �� ��� A4e Mss 4w '
C—t Page# 1 of 1
Sakvk- )V
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
Lush, Tamisa
4868 Ashbrook Drive Date Due
Noblesville, IN 46062
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
$ 74.00
9117112 981716 Refund
Total $ 74.00
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.
Lush, Tamisa Allowed 20
4868 Ashbrook Drive
Noblesville, IN 46062
In Sum of$
$ 74.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-42 981716 4358400 $ 74.00 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
20-Sep 2012
Signature
$ 74.00 _ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund