213186 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 366555 Page 1 of 1
ONE CIVIC SQUARE TAYLOR STOLL
CARMEL, INDIANA 46032 272 PROVIDENCE BLVD CHECK AMOUNT: $495.00
CARMEL IN 46032
CHECK NUMBER: 213186
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 495 . 00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 946250
Carmel * Clad Payment Date: 09/10/12
Household #: 45876
(arks&Recreation
Monon Community Center -` Taylor Stoll Hm Ph: (812)455-6412
Carmel IN 46032 272 Providence blvd
SEP 12 2012 Carmel IN 46032 Cell Ph:
Phone: (317)848-7275 taylorhstoll @gmail.com
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 495.00
Enrollee Name: Taylor Stoll Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 227001-01 Men's Basketball Lea 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09/04/2012 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Gymnasium C Class Dates: 09/19/2012 to 12/12/2012
Monon Community Cntr 7:OOP to 10:OOP
W
Carmel, IN 46032 Scheduled Sessions: 12
(317)848-7275
Skip Days 11/21/2012
Add'I Locations: Gymnasium B Class Dates: 09/19/2012 to 12/12/2012
Monon Community Cntr Meeting Times (W) 7:OOP to 10:OOP
Carmel, IN 46032
3178487275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/10/12 @ 14:29:34 by MML FEES CHANGED ON CANCELLED ITEMS(+) 495.00-
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 495.00
NEW NET HOUSEHOLD BALANCE " 0.00
Refund of=_> 495.00 Made By=_>REFUND FINAN With Reference=_>low enrollment
All refunds are subject to State Board of Accounts claim procedure and t 6 weeks to process. A check will be
issued. cash or credit card refunds.
/U jZ 9 so (Z
Authorize Signature Date AuXoriz ed ignature Date
1661 e-11 ,
Page# 1 of 2
�/ ACTIVITY REFUND RECEIPT
IiJ Receipt# 946250
rs&recreation Payment Date: 09/10/2012
Household#: 45876
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# 2 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.
Stoll, Taylor Terms
272 Providence Blvd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/10/12 946250 Refund $ 495.00
Total $ 495.00
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.
Stoll, Taylor Allowed 20
272 Providence Blvd
Carmel, IN 46032
In Sum of$
$ 495.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept ept# INVOICE NO. ACCT#/TITLE AMOUNT
1096-50 946250 4358400 $ 495.00 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
$ 495.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund