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242028 02/10/15 r Coq �. CITY OF CARMEL, INDIANA VENDOR: 367745 ® CHECK AMOUNT: $"**""*"*25.00* Y ONE CIVIC SQUARE MICHAEL KILPATRICK CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 242028 CHECK DATE: 02/10/15 9MlTON G�; DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4344100 REIMB 25.00 CELLULAR PHONE FEES Carmel ® Clay Parks&Recrea ion Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense 1/15/2015 Verizon 1091 �4 3 u Lq 100 cell phone reimbersment $ 25.00 cell phone reimbersment 'Dec `1 L+ 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 FEB -3 2015 payable to: City, St, Zip Sheridan In. 46069 BY: Signature: %k �/�i / � 11LL /r!�� Approved by: --— va�i Date: 2/2/2015 Date: 'z Is GS Business Services Division,Revised 7-7-08 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request Manage Your Account Account Number Date Due r P.O.BOX 4002481,004485-00001 :0 VertZgMvireless ACWORTH,GA 30101 Change your address at Invoice Number 3180157675 vzw.com/changeaddress 0066522 01 AV 0.378 "AUTO T41 4820 46069-872535 -=-P66588-I Quick Bill Summary Nov 21 —Dec 20 1111111111'11iI"'111111111'11111'1111"'1'1111"III'IIIIII'lllll RENEE KILPATRICK Previous Balance(see back for details) $145.73 2335 W 236TH ST E Payment—Thank You —$145.73 SHERIDAN,IN 46069-8725 Balance Forward $.00 Monthly Charges $127.98 Usage and Purchase Charges $.45 Verizon Wireless'Surcharges and Other Charges&Credits $39.28 Taxes,Governmental Surcharges&Fees $12.25 ' Total Current ChargesF $179.96 Veriiori Wireless:News Change To Your ServiceTotal Charges Due by January 15, 2015 $179.96 Thank you for your wireless business. You recently made a change to your service. Your new bill will reflect usage from your last bill and service adjustments resulting from the plantfeature change. - ' Add.o smortphone to `. EASILY STAY . CONNECTED., Questions: Pay from Wireless Pay on the Web - - ` --�---- #PMT(P :0� • • .768) My Verizon at www.verizonwireless.com ------------------------------------ \ / VN - Bill Date December 20,2014 ver- nwvefess Account Number 481004485-00001 Invoice Number 3180157675 Please Recycle RENEE KILPATRICK 2335 W 236TH ST Total Amount Due by January 15, 2015 SHERIDAN,IN 46069-8725 Make check payable to Verizon Wireless. $179.96 Please return remit slip with payment. . . $ 000 ■ 110 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. o :..., - ni1111'1111�11111nIIII�Ini1�11i11111�111'1111111111111111'1111 ❑ Check here and fill out the back of this slip if your billing address has changed or you are adding or changing your email address. 318015767501048100448500001000000],7996000000179963 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. _ VOrIMV!Iwireless Invoice Number Account Number Date Due Page 3180157675 00448 Get Minutes Used Get Data Used Get Balance Explanation of Charges Payments Verizon Wireless'Surcharges Previous Balance $145.73 Verizon Wireless' Surcharges include () a Regulatory Charge (which helps defray various government charges we pay including Payment–Thank You government number administration and license fees); (H) a Payment Received 12/09/14 –145.73 r.—. Federal Universal Service Charge (and, if applicable, a State Universal Service Charge)to recover charges imposed on us by Total Payments 41145.73 the government to support universal service; and (iii) an Administrative Charge, which helps defray certain expenses we Balance Forward $.00 incur, including:charges we, or our agents, pay local telephone companies for delivering calls from our customers to their Account Charges and Credits 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 12/21 –01/20 70.00 are-subject-to change-from-time-to-time.-l– 15%Access Discount($70.00+$9.99) 12/21 –01/20 –12.00 Subtotal $58.00 Taxes,Governmental Surcharges and Fees Includes sales, excise and other taxes and governmental surcharges and fees that we are required by law to bill Total Account Charges and Credits $58.00 customers.These taxes, surcharges and fees may change from time to time without notice. Understanding Your Prorated(partial month)Charges Prorated charges occur when you add new service, or make a change to your existing service, in the middle of your bill cycle. Prorated charges are calculated by determining the daily charge, and then by multiplying the daily charge by the number of days the service was used. 11 a plan change is effective as of a date during the bill cycle,your proration will include a credit for unused days on the old plan, and a charge for the days used on your new plan. �orrespgndence Address Verizon Wireless Attn Correspondence Team Pfl 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..)agree that Verizbn-Wreless 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.comfGhangeaddress 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. NewAddressConfirming 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 PC Box)that is the home or primary State/Zip business address of the person who uses that number.To Wolk Phone Home Phone confirm or change the service address for any of your mobile numbers,sign in to My Verizon at vzw.comlserviceaddress. Email 0066522-0253005-0000002 Of0000010-007-LTA820-66588 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 1/15/15 Reimb Cell phone charges Dec'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 Sheridan, IN 46069 In Sum of$ I $ 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 February 5, 2015 l W Signature $ 25.00 Accounts Payable Coordinator Cost distribution ledger classification if i Title claim paid motor vehicle highway fund SII I