HomeMy WebLinkAbout237328 09/23/14 CITY OF CARMEL, INDIANA VENDOR: 365288
ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $********50.00*
a CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD CHECK NUMBER: 237328
9y�TON WESTFIELD IN 46074 CHECK DATE: 09/23/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50.00 CELLULAR PHONE FEES
DUE BY; Sep 19, 2014 $181.00
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:
CHECK FOR AUTO PAY AT&T MOBILITY
(SEE REVERSE) PO BOX 6416.
CAROL STREAM IL,60197-6416
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If I enroll in AutoPay,I authorize AT&T to pay my bill
�I�II�III'I'lll�lll.'I�'lll��ll���'ll'I"�I'�IIII'I�'��I�I'll"I'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:
Carmel Clay
Parks&kecr-cation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
9/2/2014 AT&T 1091 4344100 Cellular Phone Fees $ 50.00 August Cell Phone Reimb.
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
Check
Address 16930 Kingsbridge Blvd
--
payable to: City, St, Zip Westfield, IN 46074
Signature: Approved by-
Date:
:Date: 9/2/2014 Date: 3 20/
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
V
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
9/2/14 Reimb' Cell phone reimbursement Aug'14 $ 50.00
Total $ 50.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
365288 Baumgartner, Kurtis Allowed 20
16930 Kingsbridge Blvd
Westfield, IN 46074
In Sum of$
$ 50.00
i
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
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
18-Sep 2014
Signature
$ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund