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HomeMy WebLinkAbout227059 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 367792 Page 1 of 1 ONE CIVIC SQUARE TAY NGUYEN CHECK AMOUNT: $15.00 CARMEL, INDIANA 46032 8524 DUMFRIES DR o� BROWNSBURG IN 46112 CHECK NUMBER: 227059 CHECK DATE: 12/11/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 15 . 00 REFUNDS AWARDS & INDE ACTIVITY REFUND RECEIPT Receipt# 1177435 Ca- reel e Clay Payment Date: 12/02/13 J Household #: 56179 Parks&Recf eatidh '7 Monon Community Center DL ® 3 2013 Tay Nguyen Hm Ph: (317)858-0063 Carmel IN 46032 8524 Dumfries Dr. ' Brownsburg IN 46112 Cell Ph:(317)985-7438 taybnguyen @gmail.com Phone: (317)848-7275 Fed Tax ID#35-6000972 Enrollment Details ROSTER CHANGE - Refund Of 15.00 Enrollee Name: Tay Nguyen Fees+Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 237006-01 MCC Fall Open 2013 22.00 0.00 22.00 0.00 0.00 Enrollment Date: 10/16/2013 (Enrolled) Class Location: Gymnasium A Class Dates: 11/09/2013 to 11/09/2013 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 12/02/13 @ 15:50:15 by MML FEES ADJUSTED ON CHANGED ITEMS(+) 15.00- NET AMOUNT FROM CHANGED ITEMS TOTAL AMOUNT AMOUNT REFUNDED 1b:00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of=_> 15.00 Made By=_>REFUND FINAN With Reference=_>cancelled 1 event All refunds are ubject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be issued Authorized Signature QQ Date Auth i d Sig ture D to 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. Nguyen, Tay Terms 8524 Dumfries Dr Date Due Brownsburg, IN 46112 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/2/13 1177435 Refund $ 15.00 Total $ 15.00 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 5-11-10-1.6 120 Clerk-Treasurer Voucher No. Warrant No. Nguyen, Tay Allowed 20 8524 Dumfries Dr Brownsburg, IN 46112 In Sum of$ $ 15.00 ON ACCOUNT OF APPROPRIATION FOR 109 -MCC PO#or Board Members Dept# INVOICE NO. ACCT#/TITL AMOUNT 1096-50 1177435 4358400 $ 15.00 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 6-Dec 2013 Signature $ 15.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund