HomeMy WebLinkAbout247926 07/28/1 5 .CAA .
,`y....__,4�. CITY OF CARMEL, INDIANA VENDOR: 368360
b ONE CIVIC SQUARE MATT KLINEMAN CHECK AMOUNT: $*******167.76*
x ,a° CARMEL, INDIANA 46032 2842 HAZEL FOSTER DRIVE CHECK NUMBER: 247926
'M�iroN�. CARMEL IN 46033 CHECK DATE: 07/28/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
854 5023990 108163921001 167.76 YOUTH COUNCIL
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Reimbursement Expense Receipt
Reimbursement expenses are transactions that were conducted by a third-party whom
needs a reimbursement on behalf of the CMYC organization. Transactions such as CMYC
members paying for CMYC event materials would be one example of a reimbursement expense.
After completing this form, please submit it to the Council Clerk-Treasurer.
Expender: Matt Klineman
Vendor(location of purchase): BlueHost
Date: 6/21/15
Event/Activity(if applicable): Website
Expense Account(see list of accounts):
Additional Description: Renewed Website and hosting for 1 year
Expense Amount(do not include Sales Tax): $167.76
Reimbursee Name: Matt Klineman
Reimbursee Address (required): 2842 Hazel Foster Dr., Carmel,IN 46033
I verify to the best of my knowledge that this information is correct, and this purchase was
Mebe a M nd not for personal use or gain.
xpender Signature Date
Please submit this form to Clerk—Treasurer along with the purchase receipt.
Appendix 14—Page 1
moo my.bluehost.com https://my.bluehost.com/cgi/billing_history/invoice/32057470
RECEIPT
BlueHost, Inc.
Affordable, Reliable, Web Hosting Solutions INVOICE No: 22613566
560 Timpanogos Pkwy Orem, UT 84097
Phone (888)4014678 Fax 801-765-1992
support@bluehost.com
Matthew Klineman
Billing Info 2842 Hazel Foster Dr.
Carmel, IN 46033
US
+1.3173414889
Matthew Klineman
Customer Info Carmel Mayor's Youth Council
One Civic Square
Carmel, IN 46032
US
+1.3173414889
payment method status paid on
IPRIOR_AUTH_CAPTURE I Paid ( 2015-06-21
description qty unit price line total
Upgrade Plus Web Hosting: cmycouncil.com 12 month $11.99/month $143.88
Renew Site Backup Pro: For cmycouncil.com account 1 year $23.88/year $23.88
$167.76 USD
Subtotal
$167.76 USD
Total
Thank you for your business!
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/21/15 Receipt $167.76
1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
120
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
Matt Klineman ALLOWED 20
IN SUM OF$
2842 Hazel Foster Drive
Carmel, IN 46033
$167.76
ON ACCOUNT OF APPROPRIATION FOR
Community Relations Gift Fund 854
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
854 I Receipt ( Mayor's Youth Council I $167.76 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
Sunday,July 26,2015
Director,Community Relations/Econo is Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund