213140 09/25/2012 =�' \4 CITY OF CARMEL, INDIANA VENDOR: 366554 Page 1 of 1
q4 � ONE CIVIC SQUARE THERESA PIERCE CHECK AMOUNT: $48.00
CARMEL, INDIANA 46032 9792 MILL CREEK PLACE
CARMEL IN 46032 CHECK NUMBER: 213140
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 48 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 951708
Payment Date: 09/17/12
Household #: 18761
P�rk Ac cre ion
SEP 19 2012
Monon Community Center Theresa Pierce Hm Ph: (317)258-3652
Carmel IN 46032 B'� ---_ - _ 9792 Mill Creek Place Wk Ph: (317)258-3652
Carmel IN 46032 Cell Ph:(317)258-3652
theresalee @hotmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 48.00
Enrollee Name: Isobel Pierce Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 223109-03 Learn To Swim Lvl 4 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 08/02/2012 (Cancelled)
Class Location: Indoor Lap Pool 4 Class Dates: 10/01/2012 to 10/22/2012
Monon Community Cntr 4:05P to 5:OOP
M
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
Cancel Reason: Advanced Request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/17/12 @ 12:41:20 by ERM FEES CHANGED ON CANCELLED ITEMS(+) 55.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 7.00-
r� AMOUNT,FR0MrCANCELLED.ITEMS :4800
C ;TOTAL.AMOUNT REF.UNDED,r�r.... 48:00 ;
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 48.00 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
issued. No cash or credit card refunds.
i7 iZ
Authorized Signature Date Authorized Signature Date
/014-/n.VISF,yv�
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.
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.
Pierce, Theresa Terms
9792 Mill Creek Place Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9117112 951708 Refund $ 48.00
Total $ 48.00
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.
Pierce, Theresa Allowed 20
9792 Mill Creek Place
Carmel, IN 46032
In Sum of$
i
$ 48.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept ept# INVOICE NO. ACCT#!TITLE AMOUNT i
1096-10 951708 4358400; $ 48.00 1 hereby certify that the attached invoice(s), or
j bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
j received except
I
l
20-Sep 2012 1
Signature
$ 48.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i