215439 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 363439 Page 1 of 1
ONE CIVIC SQUARE USA TABLE TENNIS CHECK AMOUNT: $623.20
CARMEL, INDIANA 46032 4065 SINTON ROAD SUITE 120
o�. COLORADO SPRINGS CO 80907 CHECK NUMBER: 215439
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 13268 623 . 20 GENERAL PROGRAM SUPPL
USA Table Tennis Invoice
4065 Sinton Rd., Suite 120 Date Invoice#
Colorado Springs, CO 80907
(719) 866-4583 11/19/2012 13268
Bill To "-7"N7
Carmel Clay Parks & Recreation
1235 Central Drive East NO
Carmel, IN 46032
BY:
P.O. No. Terms Project
Due upon Receipt
Quantity Description Rate Amount
Tournament Report Fees for MCC Fall Open 2012
3 Adult 1 Year Membership Fees 49.00 147.00
1 Junior 1 Year Membership Fee 25.00 25.00
4 College 1 Year Membership Fees 25.00 100.00
Club Membership Discount(15%) -40.80 -40.80
56 Tournament Processing Fee 7.00 392.00
Purchase U
Description (� w r�6
Sc^ }� a�
P.O.# —Poo
G.L.#
Budget
Line Descr
Purchaser Date II Z
Approval`" Date Al l .1
Please reference invoice number with your payment-Thank you.
Total $623.20
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.
USA Table Tennis Terms
4065 Sinton Rd., Ste 120
Colorado Springs, CO 80907
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
11/19/12 13268 Fees for membership & rating 29183 $ 623.20
Total $ 623.20
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.
USA Table Tennis Allowed 20
4065 Sinton Rd., Ste,120
Colorado Springs;C0 80907
In Sum of$
$ 623.20
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-50 13268 4239039 $ 623.20 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
6-Dec 2012
Signature
$ 623.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund