HomeMy WebLinkAbout246204 06/17/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 365288
ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $*******169.98*
CARMEL, INDIANA 46032 16930 KINGSBRIDGE WSTFIELD IN 46074 LVD CHECK NUMBER: 246204
CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50.00 CELLULAR PHONE FEES
1096 4239039 REIMB 119.98 GENERAL PROGRAM SUPPL
Carmel Clair
brks&Reereatioh ;
Employee Expense Reimbursement Request
Date of Fund Account Account _
Receipt Vendor listed on receipt # Line#- Budget Description Amount Purpose of Expense
dem rn�
6/5/2015 AT&T 1091 4344100 Cellular Phone Fees $ 50.00 Cell Reimbursement
All receipts should be attached in the same:order as listed above.
No sales tax will be reimbursed. TOTAL: $-50-010V
Employee Name(print) Kurtis Baumgartner
Addres's 16930 Kingsbridge Blvd
Check
payable to: City, St, Zip WeqffieK IN 46074
Signature: Approved by:
Date: 6/5/2015 Date: S--
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
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
5/29/2015 Dick's Sporting Goods 1096-22 4239039 Program Supplies $ 119.98 Fitness Center Dumbbells
All receipts should be attached in the same'order.as listed above.
No sales tax will be reimbursed. TOTAL: $119.98
Employee Name(print) Kurtis Baumgartner
Check Address 16930 Kingsbridge Blvd A
payable to: City, St, Zip Westfield, IN 46074 JUN 2 2015
Signature: Approved by: :__._____.__
00,
Date: 5/29/2015 Date:
Business Services Division,Revised 7-7-08
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FILE: Shared\Forms\Business Services\Employee Exp Reimb Request1
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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
6/5/15 Reimb Cell phone reimbursement May'15 $ 50.00
5/29/15 Reimb Fitness Center Dumbbells Dick's Sporting Goods $ 119.98
Total, $ 169.98
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with I C 5-11-10-1.6
, 20—
Clerk-Treasurer
Voucher No. Warrant No.
365288 Baumgartner, Kurtis Allowed 20
16930 Kingsbridge Blvd
Westfield, IN 46074
In Sum of$
$ 169.98
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1091 Reimb 4344100 $ 50.00 1 hereby certify that the attached invoice(s), or
1096-22 Reimb 4239039 $ 119.98 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
June 11, 2015
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Signature
$ 169.98 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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