246413 06/1 7/1 5 (`c� °\� CITY OF CARMEL, INDIANA VENDOR: 368259
1 ONE CIVIC SQUARE SHAUNA LEWALLEN CHECK AMOUNT: $********25.00*
'' 17317 PINE WOOD LANE CHECK NUMBER: 246413
f9M ,_�; CARMEL, INDIANA 46032 WESTFIELD IN 46074 CHECK DATE: 06/17/15
ITON GO•
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 25.00 CELLULAR PHONE FEES
Carmel 0 Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
5/25/2015 Republic Wireless 1091 4344100 Cellular Phone Fees $25 Cell phone charges for May
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $25.00
Employee Name(print) Shauna Lewallen
Address 15066 Redcliff Drive
Check
payable to: City, St, Zip Noblesville, IN 46062
Signature: �Q�(/(/�� Approved b
Date: 6/1/2015 Date: UJ L12/1S
i
i y I
j JUN - 2 2015
Republic Wireless Page 1 of 1
Invoice INVO4588444 Billing Address
May 25,2015 Shauna Lewallen
Account:Aoo118873
17317 PINE WOOD LN
WESTFIELD,IN 46o74-8940
Summary
Description Total ^. .
Monthly Total: $25.00
L
- 2015
One-Time Total: $0.00
Taxes: $3.94
Invoice Total: $28.94
Payment:(Includes any available account credits) ($28.94)
Balance Due:
$0.00
Monthly Charges
Charge Detail
(317)427-5511-Moto X Wi-Fi+Cell+3G $25.00
Service Plan
E911(Wireless)-County(2o.00%)
$0.20,
E911(Wireless)-State(iy.00sa) $0.19
State Universal Service Fund-State(o.68%) $0.18
Sales Tax-State(6.00%) $1.61
Fed USF Cellular-Federal(7.4090 $1.62
FCC Regulatory Fee(Wireless)-Federal $0.02
(:.50%)
Federal Compliance Fee-Federal(1.22%) $0.12
Monthly Subtotal: $25.00
Monthly Taxes: $3.94
2014,Republic Wireless,a division of Bandwidth.com,Inc.
Motorola,Moto X,Moto G and the Stylized M Logo are registered trademarks of Motorola Trademark Holdings,LLC.SOL REPUBLIC is a registered trademark of SOL REPUBLIC.GrWin,CaseMate and Pourer Support arc trademarks of
thei—peetiven—ers. .
https://republicwireless.com/myaccount/invoices/invoice_details/2c92aOaa4d66622f,o l4d8al 75c 12... 6/1/2015
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.'
368259 Lewallen, Shauna Terms
15066 Redcliff Drive
Noblesville, IN 46062
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
5/25/15 Reimb Cell phone May'15 $ 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. `
368259 Lewallen, Shauna Allowed 20
15066 Redcliff Drive
Noblesville, IN 46062 j
j In Sum of$
$ 25.00
ON ACCOUNT OF APPROPRIATION FOR
i
I
109 -Monon Center
PO#orl Board Members
I INVOICE NO. 4CCT#rFITLE AMOUNT I
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
i
materials or services itemized thereon for
j which charge is made were ordered and
i
J received except
i
I
i
June 11, 2015
i
Signature
$ 25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund