HomeMy WebLinkAbout229397 2/25/2014 Cyy` CITY OF CARMEL, INDIANA VENDOR: 365288 Page 1 of 1
ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD
WESTFIELD IN 46074 CHECK NUMBER: 229397
CHECK DATE: 2/25/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 50 . 00 CELLULAR PHONE FEES
DUE BY: Feb 19, 2014 $365.64 e5,wy Cti�)
Past Due Charges-$180.20- Please Pay Immediately KURTIS BAUMGARTNER
Account Number 243007377604 16930 KINGSBRIDGE BLVD
at&t WESTFIELD,IN 46074-7800
Please include account number on your check.
Make checks payable to:
0 CHECK FOR AUTO PAY AT&T MOBILITY
(SEE REVERSE) PO BOX 6416
CAROL STREAM IL 60197-6416
9740024300737760400000000D18544000D0036564001
8223.2.20.4481 1 AV 0.381 6n AutoPay Enrollment
If I enroll in AutoPay,I authorize AT&T to pay my bill
'�IIIIIIIIIIII'I' 'llllll�'�II�II'll'llll„II'�'I'��"III'll�ll�l monthly by electronically deducting money from my bank
account.I can cancel authorization by notifying AT&T at
KURTIS BAUMGARTNER www.att.com or by.calling the customer care number
16930 KINGSBRIDGE BLVD listed on my bill.
WESTFIELD IN 46074-7800 Bank Account Holder Signature:
Date:
Carmel Clay
Fear s&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
2/19/2014 AT&T 1091 4344100 Cdl�� K","I Peas $ 50.00 Cell Phone Reimbursement
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $50.00
Employee Name (print) Kurtis Baumgartner R '� FJN 717,
Address 16930 Kingsbridge Blvd FEB 10 2014
Check
payable to: City, St, Zip tfi Id, IN 46074 1—B
Signature: Approved by:
Date: 2/6/2014 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
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.
365288 Baumgartner, Kurtis Terms
16930 Kingsbridge Blvd
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
2/19/14 Reimb Cell phone reimbursement Jan'14 $ 50.00
Total $ 50.00
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.
365288 Baumgartner, Kurtis
Allowed 20
16930 Kingsbridge Blvd
Westfield, IN 46074
In Sum of$
I
$ 50.00
ON ACCOUNT OF APPROPRIATION FOR
10g -Monon Center
Board Members
PO#or INVOICE NO. CCT#/TITL AMOUNT
Dept#
1091 Reimb 4344100 $ 50.00 1 hereby certify that the attached invoice e 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
20-Feb 2014
Signature
$ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund