HomeMy WebLinkAbout216010 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 366809 Page 1 of 1
} 0 ONE CIVIC SQUARE JEAN DAGUERRE
�t?o CARMEL, INDIANA 46032 16029 VIKING LAIR ROAD CHECK AMOUNT: $20.00
WESTFIELD IN 46074 CHECK NUMBER: 216010
CHECK DATE: 11912013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 20 . 00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt# 985811
Carmel s 118y Payment Date: 12/24/12
J rks&Rec eatiOfl Household #: 46041
Monon Community Center Jean Daguerre Hm Ph: (317)804-2274
Carmel IN 46032 16029 Viking Lair Rd
Westfield IN 46074 Cell Ph:(503)807-5437
jean_marie_daguerre @yahoo.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 20.00
Enrollee Name: James Hall Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 338002-01 Fantastic Friday 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/05/2012 (Cancelled)
Class Location: Pool Observation Rm Class Dates: 01/18/2013 to 01/18/2013
Monon Community Cntr 6:OOP to 8:30P
F
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: Conflict
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 12/24/12 @ 11:44:50 by BNT FEES CHANGED ON CANCELLED ITEMS(+) 20.00-
NET AMOUNT FROM CANCELLED ITEMS 20.00-
TOTAL AMOUNT REFUNDED 20.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 20.00 Made By=_>REFUND FINAN With Reference=_>
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
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Authorized Signature \J Date t Aut orized Signature Date
Escape Day Passes are non-refundable.
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.
Daguerre, Jean Terms
16029 Viking Lair Rd Date Due
Westfield, IN 46074
Invoice- Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12124112 985811 Refund $ 20.00
Total $ 20.00
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.
Daguerre, Jean Allowed 20
16029 Viking Lair Rd j
Westfield, IN 46074
In Sum of$
$ 20.00 j
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
!
1096-70 985811 4358400 $ 20.00 I 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
I
3-Jan 2013
I
Signature
$ 20.00 Accounts Payable Coordinator
Cost distribution ledger classification if ( Title
claim paid motor vehicle highway fund
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