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Home My WebLink About240343 12/16/2014 i u�C,FM �/ \F� CITY OF CARMEL, INDIANA VENDOR: 367745 ONE CIVIC SQUARE MICHAEL KILPATRICK CHECK AMOUNT: $********25.00* ,. =a CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 240343 'Mj�TON��p` CHECK DATE: 12/16/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4344100 REIMB 25.00 CELLULAR PHONE FEES Carmel 9 Clay Parks&Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense 12/9/2014 Verizon $ 25.00 cell phone reinbursment for Nov. All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: $25.00 Employee Name(print) Mike Kilpatrick Address 2335 west 236th St. Check 1;'0 2014 payable to: City, St, Zip Sheridian In. 46069 77DE:C Signature: �� Approved by: Date: 12/9/2014 Date: Z Business Services Division,Revised 7-7-08 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request Manage Your Account Account Number Date Due l YI P.O.BOX 4002 x; ACWORTH,GA 30101 i Change your address at Invoice Number y 3166163447 vzw.com/changeaddress I 0067110 01 AV 0.378 "AUTO 701472046069-872535 -C07-P67177-1 Quick Dill Summary Oct 21 —Nov 20 1111111"111111 11'11'1'11 I II I"II'I"II"I II II III IIII�III IIIII IIS RENEE KILPATRICK Previous Balance(see back for details) $145.31 2335 W 236TH ST Payment—Thank You SHERIDAN,IN 46069-8725 —$145.31 Balance Forward $.00 Monthly Charges $124.36 Usage and Purchase Charges $2.20 Verizon Wireless'Surcharges and Other Charges&Credits $8.90 Taxes,Governmental Surcharges&Fees $10.27 Total Current Charges $145.73 Verizon Wireless News . Celebrate The Halidap Total Charges Date by December 15, 2014 $145.73 Unwrap more value and more fun this season with wireless gifts from Verizon— all powered by America's largest 4G LTE Network.Visit go.vzw.com/holiday. You're eligible for a NEW PHONE UPGRADE. See back page for details. Pay from Wireless I Pay on the web Questions: .. .: VN vlverr✓"aM wireless Bill Date November 20,2014 P , Account Number 481004485-00001 r,t �1t Invoice Number 3166163447 RENEE KILPATRICK fA 2335 W 236TH ST 1�81 iq Total Amount Due'by December 15 2014 SHERIDAN,IN 46069-8725 Make check payable to Verizon Wireless. Please return this remit slip with payment. $145.73 r El1 ■ El� Scan To Pay Or Go Paperless Pay your bill online,or enroll in Paperless Billing P.O.BOX 25505 or Auto Pay.Simply scan the QR code with your ,; LEHIGH VALLEY, PA 18002-5505 mobile device or visit vzw.com/myverizon. ❑ Check here and fill out the back of this slip if your billing address 1111'111111111111'11111111'1'11'111"11111"ll'11'1'I'111'11111' has changed or you are adding or changing your email address. 31661634470104810044850000100000014573000000145733 NOTICE:Bank account and routing numbers will be retained to enable future payments by phone or online.To opt out,call 1-866-544-0401. F "Ienzonw'refess Invoice Number Account Number Date Due Paqe 3iF6163447 48'i 004485=0000 i i 15,/14 2 t3f 7 Get Minutes Used Get Data Used Get Balance b D' D WD Explanation of Charges Payments Verizon Wireless'Surcharges Previous Balance $145.31 Verizon Wireless' Surcharges include (i) a Regulatory Charge (which helps defray various government charges we pay including Payment—Thank You government number administration and license fees); (ii) a Payment Received 11/04/14 —145.31 Federal Universal Service Charge (and, if applicable, a State Universal Service Charge)to recover charges imposed on us by Total Payments $145.31 the government to support universal service; and (ii) an Balance Forward $.�� Administrative Charge, which helps defray certain expenses we C incur, including:charges we,or our agents, pay local telephone Account Charges and Credits companies for delivering calls from our customers to their customers;fees and assessments on our network facilities and services; property taxes; and the costs we incur responding to Account Monthly Charges regulatory obligations. Please note that these are Verizon Wireless charges,not taxes.These charges,and what's included, Nationwide Talk Share 1400 11/21 —12/20 70.00 are subject to change from time to time. 15%Access Discount($70.00+$9.99) 11/21 —12/20 —12.00 Subtotal $58.00 Taxes,Governmental Surcharges and Fees Includes sales, excise and other taxes and governmental Total Account Charges and Credits $58.00 surcharges and fees that we are required'.by law to bill customers.These taxes, surcharges and fees may change from time to time without notice. Late Fee Information A late payment applies for unpaid balances.The charge is the greater of$5 or 1.5%per month,or as permitted by law. Verizon Wireless'Other Charges and Credits Includes charges for products and services,and credits owing. _Correspondence Address Verizon Wireless Attn Gorrspondence Team PO Box 5029 Waliingford,CT 06492 Automatic Payment Enrollment for Account:481004485-00001 RENEE KILPATRICK By signing below,you authorize Verizon Wireless to electronically debit your bank account each month for the total balance due on your account.The check you send will be used to setup Automatic Payment.You will be notified each month of the date and amount of the debit 10 days in advance of the payment. I understand and accept these terms:This agreement does not alter the terms of your existing Customer Agreement.I agree that Verizon Wireless is not liable for erroneous bill statements or incorrect debits to my account.To withdraw your authorization you must call Verizon ,Wireless.Check with your bank for any-charges. 1.Check this box. 2.Sign name in box below,as shown on the bill and date. 3.Return this slip with your payment.Do not send a voided check. ■ ❑ ■ Changing your billing address for Account:481004485-00001 RENEE KILPATRICK Use this space or sign in to My Verizon at vzw.com/changeaddress to change the mailing address where we send your bill.If we do not have your most recent email address,provide it below and we'll use it to tell you important information about your Verizon Wireless service.Allow 2 billing cycles for the address change to take effect. New Address -Confirming or changing your service address For each of your mobile numbers,in order to bill taxes and City surcharges'correctly we need a service address-which is a street address(not a PO Box)that is the home or primary State2ip business address of the person who uses that number.To Work Phone Home Phone confirm or change the service address for any of your mobile numbers,sign in to My Verizon at vzw.com/serviceaddress. Email 0067110-0254233-0000002 of0000010-C07-LTA720-67177 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. 367745 Kilpatrick, Michael Terms 2335 West 236 St Sheridan, IN 46069 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 12/9/14 Reimb Cell phone charges Nov'14 $ 25.00 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. 367745 Kilpatrick, Michael Allowed 20 2335 West 236 St I� Sheridan, IN 46069 � In Sum of$ $ 25.00 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 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 12-Dec 2014 Signature $ 25.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund