214592 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 366713 Page 1 of 1
ONE CIVIC SQUARE AARON CASE CHECK AMOUNT: $25.00
�l+a CARMEL, INDIANA 46032 9835 HAVERSTICK ROAD
oM.o INDIANAPOLIS IN 46280 CHECK NUMBER: 214592
CHECK DATE: 11120/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 25 . 00 REFUND
S•;k:
ACTIVITY REFUND RECEIPT
Receipt# 966584
Carmel C
Payment Date: 11/05/12
Household#: 48528 }
Monon Community Center Aaron Case Hm Ph: (31:7-)4+1!2=4008
Carmel IN 46032 NOV 0 7 2012 9835 Haverstick Road
Indianapolis In 46280 Cell Ph:(3.17)881-7445
caseml @sbcglobal.net
Phone: (317)848-7275 BY:
Fed Tax ID#35-6000972
Enrollment Details `
CANCELLATION - Refund Of 25.00
Enrollee Name: Mary Case Fees+Tax Discount Prev Paid Cur Paid'-`' Amount Due
Activity Number: 224500-02 On the Trail to Fitn 0.00 0.00 0.00 0.00-:Y;, , 'o_oo
Enrollment Date: 10/30/2012 (Cancelled)
Class Location: No Room Needed Class Dates: 11/07/2012 to 12/19/2012
Monon Community Cntr 10:OOA to 11:OOA
Carmel, IN 46032 Scheduled Sessions: 6
(317)848-7275 ''"
Skip Days 11/21/2012
Cancel Reason: Low enrollment.
PREVIOUS NET HOUSEHOLD BALANCE °: :;. ., r O:oo
Processed on 11/05/12 @ 15:01:08 by LWW FEES CHANGED ON CANCELLED ITEMS 25`:00-
NET:AMOUNT FROM CANCELLED`ITEMS ';F `,;:".
TOTAL AMOUNT REFUNDED
NEW NET HOUSEHOLD BALANCE ';; 000
Refund of=_> 25.00 Made By REFUND FINAN With Reference=_>Check refund
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refurtR ill be-.7-,
- _ -issued.
Authorized Signature Date Authori ed ig ature Date ;
Spend a relaxing evening taking a walk through the winter wonderland at Central Park on Saturday, December 1, from�'6t9pm;r F.:f,
Enjoy carolers and hot chocolate as you take in the ambiance of more than 1,000 luminaries lighting the path throufftf e
wetlands, floating over the lagoon, and spanning across the boardwalk. A beautiful sight of the 161-acre park is sur,'e;to b`e a
memory for you and your family. Free to the public. Register at carmelclayparks.com. rr
Escape Day Passes are non-refundable.
3Nage;#
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.
Case, Aaron Terms
9835 Haverstick Road Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/12 966584 Refund $ 25.00
'Total $ 25.00
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.
Case, Aaron Allowed 20
9835 Haverstick Road
Indianapolis, IN 46280
In Sum of$
$ 25.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-22 966584 4358400 $ 25.00 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
15-Nov 2012
Signature
$ 25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund