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Home My WebLink About240222 12/16/14 +ot_CLAM t. CITY OF CARMEL, INDIANA VENDOR: 365288 I; �; ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $*******100.00' ,_� CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD CHECK NUMBER: 240222 M,«oN�� WESTFIELD IN 46074 CHECK DATE: 12/16/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4344100 REIMB 100.00 CELLULAR PHONE FEES .� . �. Carmel e Clay I Parks&Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense 11/19/2014 AT&T 1091 4344100 Cellular Fees $ 50.001 October reimbursement 12/19/2014 AT&T 1091 4344100 Cellular Fees $ 50.00 November reimbursement All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: $100.00 Employee Name(print) Kurtis Baumgartner Address 16930 Kingsbridge Blvd Check DEC 9 2014 payable to: City, St, Zip Westfiel IN 46074 �Y: Signature: Approved by: i Date: )/12/8/2014 Date: /'j Business Services Division,Revised 7-7-08 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request DUE BY: Nov 19, 2014 $181.08 , KURTISBAUMGARTNER i 16930 KINGSBRIDGE BLVD c�= . Account Number. 243007377604 !r WESTFIELD,IN 46074-7800 41--f� at&t ®-$- __.: Please include account number on your check. Make checks payable to: n CHECK FOR AUTO PAY AT&T MOBILITY (SEE REVERSE) PO BOX 6416 CAROL STREAM IL 60197-6416 Il��l�ilil�ll�ll�ll�ilililili.�Il�llll�l�ni�llllnlill�l�l��l��: . 97400243D073776D40ODDD000D181080000D018108006 i 7284.2.29.7464 1 AV 0.361 6n AutoPay Enrollment ' If I enroll in AutoPay,I authorize AT&T to pay,my bill I' I'I"II'III' 'll�'I�i�ll�l�lll�lll�l�ll"'I�III�illl'�'�III�� 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.Your,enrollment could take 1-2 billing WESTFIELD IN 46074-7800 cycles for AutoPay to take effect.Continue to submit payment until page one of your invoice reflects either Your Bank Account will be Debited by or Your Credit Card will be Debited on or after. Bank Account Holder Signature: Date: DUE BY: Dec 19, 2014 $367.16 < Past Due Charges-$181.08-Please Pay Immediately KURTIS BAUMGARTNER ' �� Account Number 243007377604 16930 KINGSBRIDGE BLVD WESTFIELD,-1N 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 1L 6019776416 97400.243007377604.0000.000001860800.000036716001 ll� • 8434.2.41.9156 1 AV 0.381 6n AutoPay Enrollment If I enroll in AutoPay,I authorize AT&T to pay my bill I'III"IIIIII'II'l111111111IIII'11'II"II111111III'III'IIIIIIIIII 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.Your enrollment could take 1-2 billing WESTFIELD IN 46074-7800 cycles for AutoPay to take.effect.Continue to submit payment until page one of your invoice reflects either Your Bank Account will be Debited by or Your Credit Card will be Debited on or after. Bank Account Holder Signature: °� Date: 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 12/8/14 Reimb Cell phone reimbursement Oct, Nov'14 $ 100.00 Total $ 100.00 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 I Voucher No. Warrant No. i 365288 Baumgartner, Kurtis Allowed 20 16930 Kingsbridge Blvd Westfield, IN 46074 In Sum of$ $ 100.00 • I i I ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 Reimb 4344100 $ 100.00 ;I I 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 D92i • ! 2014 I i �i Signature $ 100.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund {