HomeMy WebLinkAbout232993 05/28/14 CITY OF CARMEL, INDIANA VENDOR: 365288
\' ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $********50.00*
CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD CHECK NUMBER: 232993
M�TaN. WESTFIELD IN 46074 CHECK DATE: 05/28/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50.00 CELLULAR PHONE FEES
DUE Bl(-May 19, 2014 $180.50
KURTIS BAUMGARTNER
1115 wag 11-0: Account Number 243007377604 16930 KINGSBRIDGE BLVD
aWWESTFIELD,IN 46074-7800
Please include account number on your check.
Make checks payable to:
CHECK FOR AUTO PAY AT&T MOBILITY,
(SEE REVERSE) PO BOX 6416 .
CAROL STREAM IL 60197-6416
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9681.17.787.1599091 AV 0.381 6n AutoPay Enrollment
' If I enroll in AutoPay;I authorize AT&T to pay my bill
IIIII'll'lllll°I'111111°IIIII'llllll°°III�II°°III°III°III°J°��°I 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:
T. 1
r
Carmel • Clay �%
a s
P rk &Recreation MAY 0 7 2014
Employee Expense Reimbursement Request B Y.
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
5/15/2014 AT&T 1091 4344100 Cellular Phone Fees $ 50.00 April Cell Phone
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
Address 16930 Kingsbridge Blvd
Check
payable to: City, St, Zip Westfield, IN 46074-7800
Signature: Approved by:
Date: $ Iq Date:
Revised 3-2-07 by Business Services;
Shared/Forms and Templates/Business Service Forms/Employee Exp Reimb Request 2007-3
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
5/15/14 Reimb Cell phone reimbursement Apr'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
i
Voucher No. Warrant No.
365288 Baumgartner, Kurtis Allowed 20
16930 Kingsbridge Blvd
Westfield, IN 46074
In Sum of$
$ 50.00
I
i
ON ACCOUNT OF APPROPRIATION FOR l
1
109 -Monon Center
I
PO#or INVOICE NO. CCT#/TITL AMOUNT f Board Members
Dept#
1091 Reimb 4344100 $ 50.00 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
t
22-May 2014
Signature
$ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund