178087 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363415 Page 1 of 1
ONE CIVIC SQUARE JIAN CHEN
CHECK AMOUNT: $75.00
CARMEL, INDIANA 46032 7528 IVYWOOD DR., APT C
INDIANAPOLIS IN 46250 CHECK NUMBER: 178087
CHECK DATE: 1 011 41200 9
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239039 9/26 USATT 75.00 GENERAL PROGRAM SUPPL
y
Carmel *Clay
Parks &Recreation CHECK REQUEST
Date:
OCT
.1 2009
Check payable to ir o
Name: 1 ct C f IN
Address: 2 5 Z-9 1 V IUV "O L t)f Apt C
City, State, Zip I h lr� A�C� 1AI 12 5 0
V Mail check to r a ee Return check to re uesf
�Y q o
Check Amount 7S f V0 Date Required �Q 2 6 Cl
Check needed for �a 2,, irk lJ O p
Supporting documentation or receipt(s) MUST be attached.
To be paid from
PO Z Z( A
Budget account GL 4 14W. 5 2.n.
Budget Line Description f
Requested by (print):
Requested by (signature):
Approved by (signature of Division Manager): q /3Q /m
on this date
Form revised 1 -21 -08
Mononkenter
AT CENTRAL PARK
Wednesday, September 30, 2009
MEMO
OCT U 1 2009
To: Audrey K, Business Services Division Manager
From: Tess Pinter, Recreation Manager
Purpose: Carmel Clay Parks Recreation hosted a Table Tennis Tournament on Saturday, September
26 All participants paid a set fee to enter the tournament. The top 3 winners in each division will
receive prize money in the form of a check. The amount per winner is below.
Division A: Division B:
1st place Joseph Cochran $250.00 1 St place Andre Khailo $150.00
2nd place Stephen Clyde $150.00 2" d pEace J la'n Chen $75.0
3 rd place David Stout $75.00 3rd place Michael Nowicki $30.00
Division C. Division D:
1St place Cameron Luo $100.00 1sc place Ken Li $75.00
2nd place Xiaofeng Guo $50.00 2 nd place Xiaofeng Guo $40.00
3rd place Ken Li $25.00 3 rd place Kevin Mi $20.00
Divison E:
1St place —Tim Stevens $75.00
2" place Craig Simon $40.00
3 rd place— Max bite $15.00
USATT Official- Al Grambo $150.00
USATT Fees- $509.00
1235 Central Park Drive East Carmel, Indiana 46032 P 317.848.7275 1 F 317.573.5254 1 www.carmelclayparks.com
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Chen, Jian Terms
7528 Ivywood Dr, Apt C
Indianapolis, IN 46250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9126109 9126 USATT USATT Tournament winner 22668 75.00
Total 75.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Cleric- Treasurer
Voucher No. Warrant No.
Chen, Jian Allowed 20
7528 Ivywood Dr, Apt C
Indianapolis, IN 46250
In Sum of$
75.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITL AMOUNT Board Members
Dept
1047 9126 USATT 4239039 75.00 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
7 -Oct 2009
Signature
75.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund