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