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Home My WebLink About224771 10/08/2013 CITY OF CARMEL, INDIANA VENDOR: 367622 Page 1 of 1 ONE CIVIC SQUARE GUADALUPE AGUIRRE CARMEL, INDIANA 46032 C/O PARKS CHECK AMOUNT: $1,024.40 +ro„ IN CHECK NUMBER: 224771 CHECK DATE: 10/812013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1092 4358400 1 1, 024 .40 REISSUE CK 224399 GLOBAL REFUND RECEIPT Receipt # 1148973 Carmel o Clay Payment Date: 09/13/13 7SEP�-��,�� Household #: 42240 Parks&Recreation 13 2013 ' Monon Community Center BY: Guadalupe Aguirre Hm Ph: (317)698-3333 Carmel IN 46032 121 Winona Dr. Wk Ph: 317)843-1393 Carmel IN 46032 Cell Ph: 317)442-8509 licho-76@hotmail.com Phone: (317)848-7275 Fed Tax ID #35-6000972 Pass Details CANCELLATION -Refund Of 1,024.40 Pass Holder: Guadalupe Aguirre Fees+Tax Discount Prey Paid Cur Paid Amount Que Pass Type: MC HH Annual (M MCHHA),#212775 115.60 0.00 115.60 0.00 0.00 Valid Dates: 08/07/2013 to 08/07/2014 (Pass Cancellation) Cancellation Effective: 09/13/2013 Pass comments: Children must be age 11 or older to utilize the pools and/or gymnasium unaccompanied by an adult. Children ages 11-13 may use Fitness Center, but must be under adullt supervision. Children must be age 14+to utilize the Fitness Center without adult supervision. Cancel Reason: moving CANCELLATION Pass Holder: Jonathon Hernandez Fees+Tax Discount Prev Paid Cur Paid Amount Due Pass Type: MC HH+ (M MCHH+), #212776 0.00 0.00 0.00 0.00 0.00 Valid Dates: 08/07/2013 to 08/07/2014 (Pass Cancellation) Cancellation Effective: 09/13/2013 Cancel Reason: moving CANCELLATION Pass Holder: Jose Luis Rivera Fees+Tax Discount Prev Paid Cur Paid Amount Due Pass Type: MC HH+(M MCHH+), #212777 0.00 0.00 0.00 0.00 0.00 Valid Dates: 08/07/2013 to 08/07/2014 (Pass Cancellation) Cancellation Effective: 09/13/2013 Cancel Reason: moving CANCELLATION Pass Holder: Xlomata abuilera Fees+Tax Discount Prev Paid Cur Paid Amount Due Pass Type: MC HH+ (M MCHH+),t#212778 0.00 0.00 0.00 0.00 0.00 Valid Dates: 08/07/2013 to 08/07/2014 (Pass Cancellation) Cancellation Effective: 09/13/2013 Cancel Reason: moving CANCELLATION Pass Holder: iosua abullera Fees+Tax Discount Prev Paid r Paid Amount Due Pass Type: MC HH+ (M MCHH+), #212779 0.00 0.00 0.00 0.00 0.00 Valid Dates: 08/07/2013 to 08/07/2014 (Pass Cancellation) Cancellation Effective: 09/13/2013 Cancel Reason: moving Page# 1 of 2 Carmel e Clay GLOBAL REFUND RECEIPT ,` Receipt# 1148973 Parks&Recreation Payment Date: 09/13/2013 Household#: 42240 CANCELLATION Pass Holder: rose Aguirre Fees+Tax Discount Prey Paid Cur Paid Amount Due Pass Type: MC HH+(M MCHH+), #212780 0.00 0.00 0.00 0.00 0.00 Valid Dates: 08/07/2013 to 08/07/2014 (Pass Cancellation) Cancellation Effective: 09/13/2013 Cancel Reason: moving PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 09/13/13®09:10:54 by JWH FEES CHANGED ON CANCELLED ITEMS(+) 1,024.40- 1 NET AMOUNT:F.ROM CANCELLED ITEMS- t 024:40 TOTAL:AMOUNT REFUNDED,..' 1'024.40" NEW NET HOUSEHOLD BALANCE 0,00 Refund of=_> 1,024.40 Made By=_>REFUND FINAN With Reference =>Moving All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be issued. Authorized Signature Date uthoriz Sig�ture Escape Day Passes are non-refundable. fr�rklOC' 1002, L135_ Wo Page# 2 of 2 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bili 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. Aguirre, Guadalupe Terms 121 Winona Dr Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/13/13 1148973 Refund $ 1,024.40 I Total $ 1,024.40 I hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and I have audited same in accordance withlC 5-11-10-1.6 20 Clerk-Treasurer Voucher No. Warrant No. Aguirre, Guadalupe Allowed 20 121 Winona Dr Carmel, IN 46032 In Sum of $ $ 1,024.40 ON ACCOUNT OF APPROPRIATION FOR 109 - MCC PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1092 1148973 4358400 $ 1 ,024.40 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 19-Sep 2013 Signature $ 1,024.40 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund