HomeMy WebLinkAbout213307 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 366574 Page 1 of 1
ONE CIVIC SQUARE BRIAN MOCK
�i CARMEL, INDIANA 46032 8950 BRADWELL PLACE#104 CHECK AMOUNT: $42.00
FISHERS IN 46037 CHECK NUMBER: 213307
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 42 . 00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
.� Receipt# 955709
...armel a Clay Payment Date: 10/04/12
'ar s&Recreation Household #: 49479
.., :...
1
,non Community Center Brian Mock Hm Ph: (317)578-1445
rmel IN 46032 0CT 0 5 2012 8950 Bradwell PI 104
Fishers IN 46037 Cell Ph:
:F r Bknrmock @att.net
one: (317)848-7275 -- --==— ---
J Tax ID#35-6000972
Irollment Details
CANCELLATION - Refund Of 42.00
Enrollee Name: Caleb Mock Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 223108-11 Learn to Swim Lvl 3 0.00 0.00 0.00 0.00 0.0(
Enrollment Date: 08/01/2012 (Cancelled)
Class Location: Indoor Lap Pool 3 Class Dates: 10/29/2012 to 11/12/2012
Monon Community Cntr 4:05P to 5:OOP
M
Carmel, IN 46032 Scheduled Sessions: 3
(317)848-7275
Cancel Reason: November Closure
PREVIOUS NET HOUSEHOLD BALANCE 0.0C
Processed on 10/04/12 @ 11:35:36 by NMH FEES CHANGED ON CANCELLED ITEMS(+) 42.0(
NET AMOU NT_FROM CANCELLED'.ITEMS 420C
TOTAL.AMOUNT'REFUNDED 42.0(
NEW NET HOUSEHOLD BALANCE 0.0C
Refund of=_> 42.00 Made By==>REFUND FINAN With Reference==>Refund Check
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.
Authorized Signature Date Authorized Signature Date
Join us at West Park on Saturday, October 6, from 4-9pm, for our Fall Food Festival & Benefit. Local food trucks, restaurants,
and beer/wine vendors compete to be the first ever Fall Food Festival Winner! Try their favorite dishes, relax with the music,
and enjoy a beautiful day at the park with your family. Help children and families participate in department-wide activities;
proceeds will help fund scholarships. $5/person entry fee. There will be an additional cost for food and drink purchases.
Register online at www.carmelclayparks.com.
Escape Day Passes are non-refundable.
3 DO
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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.
Mock, Brian Terms
8950 Bradwell PI 104 Date Due
Fishers, IN 46037
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1014112 955709 Refund $ 42.00
Total $ 42.00
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.
Mock, Brian Allowed 20
8950 Bradwell PI 104 j
Fishers, IN 46037
In Sum of$
I
$ 42.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-10 955709 4358400 $ 42.00 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
4-Oct 2012
1Ah �
Signature
$ 42.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund