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Home My WebLink About217263 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 366181 Page 1 of 1 ` ONE CIVIC SQUARE MIDWEST ACADEMY,INC CARMEL, INDIANA 46032 801 CONGRESSIONAL BLDG SUITE 600 CHECK AMOUNT: $183.75 4i„�or7-o:? CARMEL IN 46032 CHECK NUMBER: 217263 CHECK DATE: 2113/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1095 4358400 1004163 183 . 75 REFUNDS AWARDS & INDE now mum" ��" FACILITY REFUND RECEIPT Receipt# 1004163 Carmel @ Clay Payment Date: 02/05/13 ,J I�3rks Household #: 39608 ��f��cre�t Monon Community Center FEB 7 X013 Midwest Academy Hm Ph: (317)843-9500 Carmel IN 46032 810 Congressional Blvd. Wk Ph: (317) - -- Carmel IN 46032 Cell Ph:(317)581-1644 Phone: (317)848-7275 Fed Tax ID#35-6000972 Facility Reservation Details CANCELLATION Facility: Monon Community Cntr, Banquet Room A Reserv.Contact: Midwest Academy, Cell: (317)581-1644 Reserv.Number: 23670 Status: Cancelled Purpose: Midwest Academy Musical Anticipated Count: 25 Date _ Day Time _ Fees+Tax Discount Prev Paid Cur Paid Amount Due 03/18/2013 Mon 3:30P to 6:30P 0.00 0.00 0.00 0.00 0.00 CANCELLATION Facility: Monon Community Cntr, Banquet Room A Reserv.Contact: Midwest Academy, Cell: (317)581-1644 Reserv.Number: 23670 status: Cancelled Purpose: Midwest Academy Musical Anticipated Count: 25 Date Day Time Fees+Tax Discount Prev Paid Cur Paid Amount Due 0311912013 Tue 3:30P to 6:30P 0.00 0.00 0.00 0.00 0.00 CANCELLATION Facility: Monon Community Cntr, Banquet Room A Reserv.Contact: Midwest Academy, Cell: (317)581-1644 Reserv.Number: 23670 Status: Cancelled Purpose: Midwest Academy Musical Anticipated Count: 25 Date Day Time Fees+Tax Discount Prev Paid Cur Paid Amount Due 03/20/2013 Wed 130P to 630P 0.00 0.00 0.00 0.00 0.00 CANCELLATION Facility: Monon Community Cntr, Banquet Room A Reserv.Contact: Midwest Academy, Cell: (317)581-1644 Reserv.Number: 23670 Status: Cancelled Purpose: Midwest Academy Musical Anticipated Count: 25 Date Day Time Fees+Tax Discount Prev Paid Cur Paid Amount Due 03/21/2013 Thu 12:30P to 7:30P 0.00 0.00 0.00 0.00 0.00 Page# 1 of 3 iN, FACILITY REFUND RECEIPT Carmc) 0 cLay Receipt# 1004163 Parks&Rccreatlon Payment Date: 02/05/2013 Household #: 39608 CANCELLATION - Refund Of 8.75 Facility: Monon Community Cntr, Banquet Room -All 3 Reserv.Contact: Midwest Academy, Cell: (317)581-1644 Reserv.Number: 23670 Status: Cancelled Purpose: Midwest Academy Musical Anticipated Count: 100 Date Day Time Fees+Tax Discount Prev Paid Cur Paid Amount Due 03/22/2013 Fri 6:OOP to 10:OOP 0.00 0.00 0.00 0.00 0.00 CANCELLATION - Refund Of 175.00 Facility: Monon Community Cntr, Banquet Room -All 3 Reserv.Contact: Midwest Academy, Cell: (317)581-1644 Reserv.Number: 23670 Status: Cancelled Purpose: Midwest Academy Musical Anticipated Count: 100 Date Day Time Fees+Tax Discount Prev Paid Cur Paid Amount Due 03/23/2013 Sat 6:OOP to 10:OOP 0.00 0.00 0.00 0.00 0.00 The following item reflects a payment towards a previous receipt Facility: Monon Community Cntr, Banquet Room -All 3 Reserv.Contact: Midwest Academy, Cell: (317)581-1644 Reserv. Number: 23637 Status: Firm Purpose: Midwest Academy Prom (RCC) Anticipated Count: 50 Date Day jime Fees+Tax Discount Prev Paid Cur Paid Amount Due 04/26/2013 Fri 8:OOP to 12:OOA 472.50 0.00 236.25 236.25 0.00 Fee Details: Fee Description _Amount _ Count Discount Sales Tax Total Fee nRental Ritz Custodi 105.00 4.50 0.00 0.00 472.50 Special Questions: How did you hear about the Monon Center: Attended another event PREVIOUS NET HOUSEHOLD BALANCE 236.25 Processed on 02/05/13 @ 15:06:52 by CLL FEES CHANGED ON CANCELLED ITEMS(+) 420.00- NET AMOUNT FROM CANCELLED ITEMS 420.00- FEES ADJUSTED ON CHANGED ITEMS(+) 0.00 NET AMOUNT FROM CHANGED ITEMS 0.00 HH BALANCE APPLIED TO THIS RECEIPT(+) 236.25 TOTAL AMOUNT REFUNDED 183.75 NEW NET HOUSEHOLD BALANCE 0.00 Page# 2 of 3 Carmel ® Clay FACILITY REFUND RECEIPT Darks&recreation Receipt# 1004163 Payment Date: 02/05/2013 Household #: 39608 Refund of=_> 183.75 Made By=_>REFUND FINAN With Reference==>Check Payment of==> 236.25 Made By=_> Facility Reservation Credit Balance All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be issued. The count for this line item will not be known until after the reservation date. Therefore, both the count and the extension are left at zero for reservation purposes, but will be updated after the reservation date. As soon as this data is available, you will be invoiced for the current amount due. Please remit to our office within 10 days of the invoice date. z 5 �5 <5� 2 1LO I�� A rize nature Date Authorized Signature Date Io�5 - 3-�4ta ozo Escape y Passes are non-refundable. Page# 3 of 3 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. Midwest Academy Terms 810 Congressional Blvd Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/5/13 1004163 Refund $ 183.75 Total $ 183.75 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. Midwest Academy Allowed 20 810 Congressional Blvd Carmel, IN 46032 In Sum of$ $ 183.75 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or Board Members De t# INVOICE NO. ACCT#/TITLE AMOUNT p 1095-3 1004163 4358400 $ 183.75 I hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the i i materials or services itemized thereon for which charge is made were ordered and received except i i i i i 8-Feb 2013 Signature $ 183.75 Accounts Payable Coordinator Cost distribution ledger classification if y Title claim paid motor vehicle highway fund