214733 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 364034 Page 1 of 1
ONE CIVIC SQUARE HUA LUO CHECK AMOUNT: $11.00
,2o CARMEL, INDIANA 46032 14023 WASHITA CT
row CARMEL IN 46033 CHECK NUMBER: 214733
CHECK DATE: 11120/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 11 . 00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
arme I Clay Receipt# 966853
@ I Payment Date: 11/06/12
F arksAccreation Household #: 22595
C TFIVED
Monon Community Center I NOV 0 7 Z01Z Hua Luo Hm Ph: (317)571-8919
Carmel IN 46032 i 14023 Washita Ct. Wk Ph: (317)370-2741
I Carmel IN 46033 Cell Ph:
tianbupa @yahoo.com
Phone: (317)848-7275 ---`""'�-
Fed Tax ID #35-6000972
Enrollment Details
ROSTER CHANGE - Refund Of 7.00
Enrollee Name: Hua LUo Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 227005-01 MCC Fall Open 2012 15.00 0.00 15.00 0.00 0.00
Enrollment Date: 10/30/2012 (Enrolled)
Class Location: Gymnasium A Class Dates: 11/10/2012 to 11/10/2012
Monon Community Cntr 8:OOA to 8:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
ROSTER CHANGE - Refund Of 4.00
Enrollee Name: Henry LUo _Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 227005-01 MCC Fall Open 2012 67.00 0.00 67.00 0.00 0.00
Enrollment Date: 10/30/2012 (Enrolled)
Class Location: Gymnasium A Class Dates: 11/10/2012 to 11/10/2012
Monon Community Cntr 8:OOA to 8:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 11/06/12 @ 12:04:33 by MML FEES ADJUSTED ON CHANGED ITEMS(+) 11.00-
NET AMOUNT FROM CHANGED ITEMS 11.00
TOTAL AMOUNT REFUNDED 11.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 11.00 Made By==>REFUND FINAN With Reference==>Overcharged MML
All refunds are subject tate Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
It
uthorized Signature Date Auth ize n re Date
Page# 1 of 2
ACTIVITY REFUND RECEIPT
Carmel ��IJ�/ Receipt# 966853
Irks&recreation Payment Date: 11/06/2012
Household#: 22595
Spend a relaxing evening taking a walk through the winter wonderland at Central'Park on Saturday, December 1, from 6-9pm.
Enjoy carolers and hot chocolate as you take in the ambiance of more than 1,000 luminaries lighting the path through the
wetlands, floating over the lagoon, and spanning across the boardwalk.-..beautiful sight of the 161-acre park is sure to be a
memory for you and your family. Free to the public. Register at carmelclayparks.com.
Escape Day Passes are non-refundable.
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.
Luo, Hua Terms
14023 Washita Ct. Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/6/12 966853 Refund $ 11.00
Total $ 11.00
I 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.
°Luo, Hua Allowed 20
14023 Washita Ct.
Carmel, IN 46033
In Sum of$
$ 11.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-50 966853 4358400 $ 11.00 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
$ 11.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund