244436 04/21/15 CITY OF CARMEL, INDIANA VENDOR: 365288
jy ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: S""'"'100.00•
CARMEL, INDIANA 46032 WESTFlE It
DGINB IIDGE LVD CHECK NUMBER: 244436
CHECK DATE: 04/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 100.00 CELLULAR PHONE FEES
DUE BY. Apr 19;,2015 $,181.3,S"
KURTIS BAUMGARTNER
16930 KINGSBRIDGE BLVD
a t&t Account Number 243011 T.�77604
WESTFIELD,IN 46074-7800
�f=P Please include account numhpr on your check.
Make checks payable to:
CHECK FOR AUTO PAY AT&T MOBILITY
(SEE REVERSE) PO BOX 6416
CAROL STREAM IL 66197-6416
Ill�lnilllnllll�l�l��ll��lrllliill�llliill'.'�I''�I�III���ll�ln .
97400243007377604000000000181380000D018138007
5691.3.126.26853 1 AT 0.406 6n AutoPay Enrollment ,
If I enroll in AutoPay,I authorize AT&T to pay my bill monthly
"�II�'IIS'�II"I"����'�I�IIII�I�I'lil�l'I'lllilll�lll'I'�IIIIII by electronically deducting money from my bank account.I can
cancel authorization by notifying AT&T at www.att.com or by
KURTIS BAUMGARTNER calling the customer care number listed on my bill.Your
16930 KINGSBRIDGE BLVD enrollment could take 1-2 billing cycles for AutoPay to take
WESTFIELD IN 46074-7800 effect. Continue to submit payment until page one of your Invoice
reflects either AutoPay will Debit Your Bank Account by or
AutoPay will Debit Your Credit Card by.
Bank Account Holder Signature:
Date:
Carmel • Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
3/19/2015 AT&T 1091 4344100 Cellular Phone Fees $ 50.00 February Cell Reimbursement
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 Baumgartnerr�_
Address 16930 Kingsbridge Blvd
APR 13 2095
Check
payable to: City, St, Zip VVesffipld, IN 46074
Signature: 4V7Approved by:
Date: 4/10/2015 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
I
I
Visit us online at: www.att.com
Wireless Statement
BItC At ,A Glance
Previous Balance $181.38
Payment - 02/17 - Thank You! $181.38CR 9, Rollover
Adjustments $0.00
Balance $0.00
New Charges $181.38 Data you don't use this month rolls over
to the next month.
Total Amount Due $181.38 Learn more at att.com/keepyourdata
Rollover Data expires atter 1 mo,or Warty plan change&is consumed after all other data allowances. CN222
Amount Due in Full by Mar 19, 2015
■ Wire[@S5 �
Se 1/l Ce :'SUm,tl(llaCY`
Group 2-Data Summary-Jan 25 thru Feb 24
Service Page Total Mobile Share 6GB with Unlimited Talk&Text - Includes 6
Wireless $181.38 gigabytes of domestic data, $15 per each additional 1
gigabyte of data.Additional monthly charge applies for each
317 607-0815 $126.94 1 device on the plan. Unlimited talk &text on mobile phones.
317 607-6164 $52.44 2 Unlimited talk on Wireless Home Phone. Mobile Hotspot,
tethering, video calling, and Visual Voicemail available
Total New Charges $181.38 with compatible devices. Unlimited domestic data usage on
the AT&T Wi-Fi Basic network.
Mobile Share
Data Used(MB)
317 607-0815 77
317 607-6164 1,244
Total 1,321
711:607--b 815.
KURTIS°BAU,MGARTNER2,
Mobile Share for Whone - Includes unlimited Anytime
l minutes, Nationwide Long Distance & Roaming, unlimited
How to Contact Us: domestic and international text, picture, and video messages
For questions about your account: 1 800 331-0500 sent or received from the U.S., Puerto Rico and the U.S.
or 611 from your cell phone Virgin Islands, Call Forward feature, Caller ID, Call Wait,
For Deaf/Hard of hearing TTY: 1 866 241-6567 Conference Call feature. Mobile Share voice and data plan
Visit us online at www.att.com required.
For Important Information about your bill, please
see the News You Can Use section (Page 3).
Return bottom portion with your check in the enclosed envelope.
Wireless services provided by AT&T Mobility,I.I.C.Payments may take 7 days to post.
DUE BY: Mar 19, 2015 $181.38
KURTIS BAUMGARTNER
' Account Number 243007377604 16930 KINGSBRIDGE BLVD
WESTFIELD, IN 46074-7800
at&tPlease include account number on your check.
Make checks payable to:
n CHECK FOR AUTO PAY AT&T MOBILITY
Carmel + Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
- Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
4/19/2015 AT&T 1091 4344100 Cellular Phone Fees $ 50.00 March Cell Reimbursement
I
Y
E
f
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $50.00
Employee Name(print) Kulrtis Baumgartner (����.�.t, T t---# j
Address 16930 Kingsbridge Blvd I
Check i 4 APR 13 2015
payable to: City, St, Zip Westfield, IN 46074
Signature: Approved by:
Date: X9/201 5 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
�I
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 Term_ s
16930 Kingsbridge Blvd
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
4/9/15 Reimb Cell phone reimbursement Feb, Mar'15 $ 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
120
Clerk-Treasurer
Voucher No. Warrant No.
365288 Baumgartner, Kurtis Allowed 20
16930 Kingsbridge Blvd
Westfield, IN 46074
In Sum of$
$ 100.00
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#orBoard Members
Dept#
INVOICE NO. CCT#ITITL AMOUNT
1091 Reimb 4344100. $ 100.00 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
April 16, 2015
'PAN"VTUA)
Signature
$ 100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund