248419 08/12/15 oi.
CITY OF CARMEL, INDIANA VENDOR: 355319
ONE CIVIC SQUARE MICHAEL KLITZING CHECK AMOUNT: $********50.00*CARMEL, INDIANA 46032 1550 REDSUNSET DRIVE CHECK NUMBER: 248419
BROWNSBURG IN 46112 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4344100 50.00 CELLULAR PHONE FEES
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
August reimbursement for use of
7/12/2015 Verizon Wireless 101 1125-1-00-4344100 Cellular Phone Fees $50.00 personal phone for Department
business
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $50.00
Employee Name(print) Michael Klitzing
Address 1550 Redsunset Dr.
Check
payable to: City, St, Zip Brownsburg, IN 46112
Signature: Approved by:
Date: 8/4/2015 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request
Manage Your Account Account Number Date Due
P.O.BOX 4002 480873963-0000108/07/15
ACWORTH,GA 30101
Change your address at Invoice Number 13272353516
vzw.com/changeadd ress
Quick Bill Summary Jun 13—Jul 12
KEYLINE
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MICHAEL W KLITZING Previous Balance (see back for details) $118.81
1550 REDSUNSET DR Payment—Thank You —$118.81
BROWNSBURG,IN 46112-7734 Balance Forward $.00
Monthly Charges $69.66
Usage and Purchase Charges
Voice $.00
Messaging $.00
Data $.00
Equipment Charges $27.08
Verizon Wireless'Surcharges
Verizon Wireless News and Other Charges&Credits $3.54
See Where You Use Data Taxes,Governmental Surcharges&Fees $4.24
The Most Total Current Charges $104.52
We know it's important to have tools to
help monitor your usage.That's why
we've created the new Data Utilization Total Charges Due by August 07, 2015 $104.52
tool in My Verizon.Now you can easily
view your data usage by category.Visit
vzw.com/datautilization.
Pay from Wireless Pay on the Web Questions:
(#768) My Verizo,n at www.vzw.com 1.800.922.0204 or*611 from your wireless
------------------------------------------------------------------------------------------------------------------------------------------
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Bill Date Jul 12,2015
V@f7�I1 wireless y 1*1&
Account Number 480873963-00001 tj
Invoice Number 3272353516 Please Recycle
MICHAEL W KLITZING
1550 REDSUNSET DR Total Amount Due by August 07, 2015
BROWNSBURG,IN 46112-7734
Make check payable to Verizon Wireless. $104 52
Please return this remit slip with payment.
❑❑❑ ■ ❑❑
P.O.BOX 25505
LEHIGH VALLEY, PA 18002-5505
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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.
32723535160104808739630000100000010452000000104528
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.
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.
355319 Klitzing, Michael Terms
1550 Redsunset Dr Date Due
Brownsburg, IN 46112
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
8/4/15 Reimb Cell phone Aug'15 $ 50.00
Total $ 50.00
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
i
Voucher No. Warrant No.
355319 Klitzing, Michael Allowed 20
1550 Redsunset Dr
Brownsburg, IN 46112
In Sum of$
$ 50.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1125 Reimb 4344100 $ 50.00 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
August 6, 2015
1pko"VA"
Signature
$ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund