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178317 10/14/2009 a CITY OF CARMEL, INDIANA VENDOR: 363436 Page 1 of 1 ONE CIVIC SQUARE MICHAEL NOWICKI CHECK AMOUNT: $30.00 CARMEL, INDIANA 46032 1411 W SUPERIOR ST APT GARDEN CHICAGO IL 60642 CHECK NUMBER: 178317 CHECK DATE: 10/14/2009 DEPARTMENT ACCO PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION 1047 4239039 30.00 GENERAL PROGRAM SUPPL Carmel Clay Parks &Recreation CHECK REQUEST 2� J Date: pCT 0 1 1009 Check payable to 7 tt a 0000e0000eo eooeasoeeo•e Name: I' ZI O(Jvyj i Address: i O( ,4?�,�c dew City, State, Zip C Cc, qp j- _Z check to payee Return check to requestor Check Amount Date Required 12 0 Check needed for L CSI r Supporting documentation or receipt(s) MUST be attached. To be paid from PO# Z2 �Gg Budget account GL T�. 4M 5ZO M 9_ Budget Line Description AlA �IpQ!q)(Av" /Q t-� Requested by (print): Requested by (signature): Approved by (signature of Division Manager): 1`Pn' on this date Form revised 1 -21 -08 y Mononkenter AT CENTRAL PARK Wednesday, September 30, 2009 MEMO OCT U 1 1009 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 8: 1St place Joseph Cochran $250.00 1 St place Andre Khailo $150.00 2nd place Stephen Clyde $150.00 2nd place Jian Chen $75.00 P X11 3 place David Stout N°owickQ$3q.00 Division C: Division D: 1 St place Cameron Luo $100.00 1 St place Ken Li $75.00 2nd place Xiaofeng Guo $50.00 2 place Xiaofeng Guo $40.00 3 place Ken Li $25.00 3 place Kevin Mi $20.00 Divison E: 1 St place Tim Stevens $75.00 2nd 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. Nowicki, Michael Terms 9 1411 W Superior St., Apt. Garden Chicago, IL 60642 Invoice Invoice [description Date Number (or note attached invoice(s) or bill(s)) PO Amount 9126109 9/26 USATT USATT Tournament winner 22668 30.00 Total 30.00 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 1 20 Clerk- Treasurer Voucher No. Warrant No. Nowicki, Michael Allowed 20 1411 W Superior St., Apt. Garden Chicago, IL 60642 In Sum of 4 30.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 9/26 USATT 4239039 30.00 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 30.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund