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178404 10/14/2009
CITY OF CARMEL, INDIANA VENDOR: 363427 Page 1 of 1 0 ONE CIVIC SQUARE DAVID STOUT CHECK AMOUNT: $75.00 CARMEL, INDIANA 46032 5913 SANDALWOOD DR CARMEL IN 46033 CHECK NUMBER: 178404 CHECK DATE: 10/14/2009 D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4239039 9/26 USATT 75.00 GENERAL PROGRAM SUPPL a 'Sr Carmel aClay Parks &Recreation CHECK REQUEST Date: '73 r 7rd OCT 0 Z 2009 Check payable to x e ...............o:..... Name: �Gt U �KT Address: a -DA K City, State, Zip C L-I Yj/ TZn ©33 Mail check to payee Return check to requestor Check Amount T S OQ Date Required Check needed for 3rd K AU i1 C -z►mua A n Tke Ror6 n Supporting documentation or receipt(s) MUST be attached. To be paid from PO 2Z(L$ Budget account GL 1, UUf� l( Z3G10; Budget Line Description AIV4 Requested by (print) Requested by (signature): �!�1�1�1 4 D Approved by (signature of Division Manager): 6 Y30 /U on this date Form revised 1 -21 -08 Mononkenter ATCENTRALPARK Wednesday, September 30, 2009 3 MEMO O C T 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 1St place Andre Khailo $150.00 2nd place Stephen Clyde $150.00 2 place Jian Chen $75.00 3 dplac D va id Stout_$7 0 3` place Michael Nowicki $30.00 Division C: Division D: 1St place —Cameron Luo $100.00 1 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 place Tim Stevens $75.00 2 nd place Craig Simon $40.00 3` piace 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 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. Stout, David B Terms 5913 Sandalwood Dr Carmel, IN 46033 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 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_ Clerk- Treasurer Voucher No. Warrant No. Stout, David B Allowed 20 5913 Sandalwood Dr Carmel, IN 46033 In Sum of '1 75.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 9/26 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