178242 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363429 Page 1 of 1
ONE CIVIC SQUARE ANDRE KHAILO CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 106 S MAPLE LANE
ue d WAKARUSA IN 46573 CHECK NUMBER: 178242
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239039 150.00 PRIZE
Carmel Clay
Parks &Recreati CHECK REQUEST
Date:
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OCT 1 2009
Check payable to
Name: Zo .......o.
Address: Ln
City, State, Zip yj av -tea -r-W If to 5`1 e s
V
Mail check to payee Return check to requesfor
Check Amount ,LJ l 1 Date Required 'Z a c,
Check needed for I S 4- n TAC= cck
2� t Oon
Supporting documentation or receipt(s) MUST be attached.
To be paid from
PO# �Z�B
Budget account GL 4 'Tl IV Z U I Q
Budget Line Description /'adult ?fof,,rr- r.
Requested by (print):
Requested by (signature):
Approved by (signature of Division Manager)
on this date
Form revised 1 -21 -08
Mononkenter
AT CENTRAL PARK
Wednesday, September 30, 2009
MEMO OC 1 1009
To: Audrey K, Business Services Division Manager Z°
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:
1 place Joseph Cochran $250.00 1 plac eA yA ri� dre, KVailo'$150.00
2 nd place Stephen Clyde $150.00 2 place Jian Chen $75.00
3 place David Stout $75.00 3 place Michael Nowicki $30.00
Division C. Division D:
1 place —Cameron Luo $100.00 1 place Ken Li $75.00
2 nd place Xiaofeng Guo $50.00 2 nd place Xiaofeng Guo $40.00
3rd place Ken Li $25.00 3` place Kevin Mi $20.00
Divison E:
1 place Tim Stevens $75.00
2 nd place Craig Simon $40.00
3 place Max Hite $15.00
USATT Official- Al Grambo $150.00
USATT Fees- $509.00
1235 Central Park Drive East Carmel, Indiana 46032 I 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.
Khailo, Andre Terms
106 S Maple Ln
Wakarusa, IN 46573
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9/26/09 9/26 USATT USATT Tournament winner 22668 150.00
Total 150.00
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
Clerk- Treasurer
Voucher No. Warrant No.
Khailo, Andre Allowed 20
106 S Maple Ln
Wakarusa, IN 46573
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 9126 USATT 4239039 150.00 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
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund