248417 08/12/15 CITY OF CARMEL, INDIANA VENDOR: 367745
® ONE CIVIC SQUARE MICHAEL KILPATRICK CHECK AMOUNT: $**......25.00*
CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 248417
9'M/roN�p� CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 25.00 CELLULAR PHONE FEES
carme'--1 0 Clay
Par s&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
7/15/2015 Verison June cell phone rembersment $ 25.00 25
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $25.00
Employee Name (print) Michael Kilpatrick ��->�' ' r
Address 2335 west 236th st. AUG — 3 2015
Check
payable to: City, St, Zip Sheridian In. 46069 BY--- ......-_— __j
Signature: A o � Approved b
Date: 7/30/2015 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
t
Manage Your Account Account Number Date Due
11011
14
P.O.BOX 4002 3262754568
ACWORTH,GA 30101 Change your address at Invoice Number
C. vzw.com/changeaddress `----
' :
Quick Bill Summary May 21 –Jun 20
0178988 01 AT 0,413 lUl 1 Ira 0 4 46069-872535 -007-P79076-1
11111'I�" I I $150.48
Previous Balance(see back for details) _$150.48
RENEE KILPATRICK Payment—Thank You $,00
2335 W 236TH ST Balance Forward
SHERIDAN,IN 46069 8725 $127.97
Monthly Charges $2.15
Usage and Purchase Charges
Verizon Wireless'Surcharges $9.49
and Other Charges&Credits $10.33
Taxes,Governmental Surcharges&Fees
$149.94
Total Current Charges
Ey
zon Wireless News $149.94
.-- Total Charges Due by July 15,2015 Look For My Verizonesigned rizon
the ourlaccount serizon me managing yith a new look and simplern,it's easy to stay up-to-datesage,billing and what mattersou.Visit vzw.com/myverizon.
1 _
I ' You're eligible fora
PHONE UPGRADE.
J See back page for details.
-- — __.–_--_– Questions:
Pay from Wireless Pay on the Web ;
VePiionwireless Invoice Number Account Number Date Due Page
3262754568 • 481004485-00001 07/15/15 3 of 7
Overview of Lines
Your Account's Plan Breakdown of Charges
i
Nationwide Talk Share 1400 I Account Charges&Credits pg 2 $58.00
$70.00 monthly charge 317-753-4848 pg3 $16.99
1400 monthly allowance minutes I Renee Kilpatrick
$.40 per minute after allowance 317-753-7940 pg 4 $17.82
Renee Kilpatrick
Unlimited Nights and Weekend 317-753-7971 pg 5 $57.13
Unlimited National M2M i Renee Kilpatrick
Friends&Family Total Current Charges $149.94
Unlimited calling to 10 numbers
Beginning on 10/21/11:
15%Access Discount Breakdown of Shared Usage
SharePlan
NGnutes Used
I
317-753-4848 pg 3 161
317-753-7940 pg4 25
317-753-7971 P95 163
Total Used 349
Shared Allowance 1,400
Usage Over Allowance U
f Total Shared Usage Charges $.00
Summary for Renee Kilpatrick: 317-753-4848
Your Pian Monthly Charges
Line Access 06/21 —07/20 9.99
Nationwide Talk Share 1400 $9'99
Pay As You Use Megabyte Data L Usage and Purchase Charges
$1.99 per megabyte
Voice Allowance Used Billable Cost
SharePlan minutes 1400 161 -- --
Have more questions about your charges? (shared)
Get details for usage charges at Friends&Family minutes -- 55 -- --
%Ww.vzw.com,Sign into My Verizon to i Mobile to Mobile minutes unlimited 429 --
View Online Bill and click on Calls, Night/Weekend minutes unlimited 309 -- --
Messages&Data. i Total Voice $.00
S
Messaging
Text—Rcv'd messages -- 1 1 .20
0
0
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.
367745 Kilpatrick, Michael Terms
2335 West 236 St
Sheridan, IN 46069
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
7/15/15 Reimb Cell phone charges Jun'15 $ 25.00
Total $ 25.00
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
20_
Clerk-Treasurer
Voucher No. Warrant No.
367745 Kilpatrick, Michael Allowed 20
2335 West 236 St
Sheridan, IN 46069
In Sum of$
$ 25.00
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
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
materials or services itemized thereon for
which charge is made were ordered and
received except
August 6, 2015
Signature
$ 25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund