178268 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363431 Page 1 of 1
ONE CIVIC SQUARE CAMERON LUO
r< CARMEL, INDIANA 46032 12715 COVERED BRIDGE ROAD CHECK AMOUNT: $100.00
SELLERSBURG IN 47172 CHECK NUMBER: 178268
ON
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239039 100.00 PRIZE
�1.
Carmel Clay
Parks &Recreation CHECK REQUEST
Date:
1 p t
Check payable to C T I ZOU9
Name: (�O JG rC)7?
a..
Address: e c- "'C "f
City, State, Zip �'S �4 i.J Il-
V1 Mail check fo a ee Return check to re uestor
P Y 9
Check Amount V� V� Date Required d Z
Check needed for �A onojn(ul 4e r
Supporting documentation or receipt(s) MUST be attached.
To be paid from
Po Ztn g
Budget account GL //`7 go o,5Z0. X1 239 0 3 6
Budget Line Description Pr DQ o rn &Qa eS
Requested by (print):
Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 1 -21 -08
ti
The
Mononkenter
AT CENTRAL PARK
Wednesday, September 30, 2009 r- r
MEMO C1 1 2009
To: Audrey K, Business Services Division Manager diY°
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:
l st place Joseph Cochran $250.00 1 st place— Andre Khailo$150.00
2n place Stephen Clyde $150.00 2nd place Jian Chen $75.00
3rd place David Stout $75.00 3rd place Michael Nowicki $30.00
Division C. Division D:
1 5 place Camero Luo $100:00` 1 5 place Ken Li $75.00
2 place Xiaofeng Guo $50.00 2 r d place Xiaofeng Guo $40.00
3 rd place Ken Li $25.00 3 rd place Kevin Mi $20.00
Divison E.
1 St place Tim Stevens $75.00
2nd place Craig Simon $40.00
3 rd place Max Hite $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 w ww.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.
Luo, Cameron Terms
12715 Covered Bridge Road
Sellersburg, IN 47172
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9126109 9126 USATT USATT Tournament winner 22668 100.00
Total 100.00
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
Luo, Cameron Allowed 20
12715 Covered Bridge Road
Sellersburg, IN 47172
In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 9126 USATT 4239039 100.00 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
Lei
Signature
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund