HomeMy WebLinkAbout226006 11/05/2013 CITY OF CARMEL, INDIANA VENDOR: T358375 Page 1 of 1
ONE CIVIC SQUARE MELISSA WARRINER
CARMEL, INDIANA 46032 12071 BAYHILL DRIVE CHECK AMOUNT: $46.00
CARMEL IN 46033 CHECK NUMBER: 226006
CHECK DATE: 11/5/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 46 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1165084 .r l 0 'C Lai
Payment Date: 10/23/2013 f
Household #: 2457 Par. & e''creatlon
Home Phone: (317)818-0509
Work Phone: (317)598-9000
OCT 2 8 2013
MELISSA WARRINER Monon Community Center
12071 BAYHILL DR. Carmel IN 46032
CARMEL IN 46033
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION -Refund Of 46.00
Pass Holder: HOlten Warriner Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Yth Mthly(M MUM), #111477 46.00 0.00 0.00 46.00 0.00
Valid Dates: 07/08/2013 to 07107/2014 (Pass Cancellation)
Cancellation Effective: 10/23/2013
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.
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
nMonthly MC Pass 46.00 1.00 0.00 0.00 46.00
Cancel Reason: Away at College. Faxed originaly cancellation in August.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 10/23/13 @ 15:48:02 by MNS FEES CHANGED ON CANCELLED ITEMS(+) 92.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES( ) 0.00
SALES TAX CHARGED ON CANCELLED FEES(+) 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 46.00-
NET:AMOUNT FROM CANCELLED ITEMS 46:00
TOTAL AMOUNT''REFUNDED, 46.00:
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 46.00 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.
1 10
Authorized Signature Date AuS orized A g 9)!V Date
Page# 1 of 2
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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.
Warriner, Melissa Terms
12071 Bayhill Dr Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/23/13 116508/4 Refund $ 46.00
Total $ 46.0
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Warriner, Melissa Allowed 20
12071 Bayhill Dr
Carmel, IN 46033
In Sum of$
$ 46.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 116508/4 4358400 $ 46.00 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
4-Nov 2013
Signature
$ 46.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund