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237444 09/23/14
1�,.CAq� \F• CITY OF CARMEL, INDIANA VENDOR: 368259 ��, CHECK AMOUNT: $****'***25.00* ONE CIVIC SQUARE SHAUNA LEWALLEN �f � CARMEL, INDIANA 46032 17317 PINE WOOD LANE CHECK NUMBER: 237444 ��TON�� WESTFIELD IN 46074 CHECK DATE: 09/23/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4344100 25.00 CELLULAR PHONE FEES Carmel e C ay Parks&Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense 8/25/2014 Republic Wireless 1091 4344100 Cellular Phone Fees $25 ell phone charges for Augusi All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: $25.00 Employee Name(print) Shauna Lewallen Address 17317 Pine Wood Lane Check payable to: City, St, Zip Westfield, IN 46074 Signature: `��Ww (VJt I,Q,{ 1 Approved by: ;oo'�. Xe-71 Date: 9/5/2014 Date: Business Services Division,Revised 7-7-08 '-1:-11 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request LSEP -8 2014 Republic Wireless Page 1 of 1 Help(https://help.republicwireless.com) Community(https://community.republicwireless.com) Blog(https://community.republicwireless.com/blogs/republic) Shop(/shop) g My Account(/myaccountl) Invoice INVO2062042 Billing Address August 25,2014 Shauna Lewallen Account:A00118873 17317 PINE WOOD LN WESTFIELD,IN 46074-8940 Summary Description Total Monthly Total: $25.00 One-Time Total: $0.00 Taxes: $3.73 ............. ..... .. ..._. Invoice Total: $28.73 Payment:Qncludes any available account credits) ($28.73) .._ .......... ._._...__. ......_ — Balance Due: $0.00, Monthly Charges Charge Detail Moto X Wi-Fi+Cell+3G Service Plan $25.00 E911(Wireless)-County(2o.009b) $0.20 w. _.. . . ... E911(Wireless)-State(fs.009b) $0.19 State Universal Service Fund-State(os49b) $0.14 Sales Tax-State 60095 $1.60 Fed USF Cellular-Federal(is7o46) $1.46 FCC Regulatory Fee(Wireless)-Federal(f.so%) $0.02 Federal Compliance Fee-Federal(t.229b) $0.12 Monthl.... . . ............ ...... . .. ._. Monthly Taxes: $3.73 MEET REPUBLIC PHONES(/PHONES) RESOURCES SUPPORT FOLLOW US KEEP UP WITH US (/MEET-REPUBLIC) Moto X(/phones/moto-x) (HTTPS://REPUBLICWIRQkEIO.UM O euMi ��s� b ablicwirele Our Mission(/our- Moto G(/phones/moto-g) Get Started(/start) Meet the Team(/support-ort- - —� mission) Activate Your Phone Press Room(/press-room) team) Our Story(/our-story) (httPs://rePublicwireless.corR&@ WPfOend Community How We Do It(ihow-we- (https://republicwireless.corUttpjstbmpntVhEleirtW�;s.com/community) Submit do-it) Affiliates(/affiliates) FAQs(/fags) Reviews(/reviews) Blog Help (http://republicwireless.con*WqU)//republicwireless.com/help) ©2014,Republic Wireless,a division of Bandwidths,Inc. Legal(/legal) (http://bandwidth.com/peoWdWmwM Motorola,Na XMefo Oand(he 5(ylvedMlogo arc reg&re ed nadems bol Mo(aro/a Tndem4H&ding;LLC.SOL RfpUBflCita Mfl�t�e�� M50I fBll� i/�i(� I��� Id��)pport are bademarks olMe/rctperfive ovmers. Service Status (http://status.republicwireless.com/) https://republicwireless.com/myaccount/invoices/invoice details/2c92aO9547f7l bc501480b... 9/5/2014 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. 368259 Lewallen, Shauna Terms 17317 Pine Wood Lane Westfield, IN 46074 I Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 8/25/14 Reimb Cell phone Aug'14 $ 25.00 i Total $ 25.00 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. 368259 Lewallen,'Shauna Allowed 20 17317 Pine Wood Lane Westfield, IN 46074 In Sum of$ $ 25.00 i ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center t# INVOICE NO. CCT#/TITL AMOUNT Board Members Deeppt# 1091 Reimb 4344100 $ 25.00 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 i i j 18-Sep 2014 r Signature f $ 25.00 ; Accounts Payable Coordinator Cost.distribution ledger classification if Title claim paid motor vehicle highway fund f i