248897 08/26/15 CITY OF CARMEL, INDIANA VENDOR: 367745
ONE CIVIC SQUARE MICHAEL KILPATRICK CHECK AMOUNT: $""""""""25.00'
CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 248897
(9-
CHECK DATE: 08/26/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 25.00 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
8/20/2015 Verizon wireless $ 25.00 cell phone rembursment
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $25.00
Employee Name(print) Mike Kilpatrick -N
-Tf TN7E
Address 2335 west 236th St.
Check AUG Z 1 2015
payable to: City, St, Zip Sheridan In. 46069 By-
Signature: &ZZ&A � _ Approved by:
Date: 8/20/2015 Date: 8120 11/}
Business Services Division, Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
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Manage Your Account Account Number Date Due
,• _ P.O.BOX 4002 ,o, ,� •_'i , :•��;: a D : t e a e �D• ;�s�``a
ACWORTH,GA 30101 .,. . . iz
Change your address ate Number 3276289240 _I
vzw.com/changeaddress L--
0 195456 02 AT 0.413 -AUTO TO 0 4320 46069-872535 -C07-P95661-11 "trick Bill Summary Jup21 -Jul 20
I1111111I11111I11111111111111III1111II1I1111111111111111111111111
RENEE KILPATRICK Previous Balance(see back for details) $149.94
2335 W 236TH ST Payment—Thank You —$175.00
SHERIDAN, IN 46069-8725
Credit Balance 425.06
Monthly Charges $127.97
Usage and Purchase Charges $1.90
Verizon Wireless'Surcharges
and Other Charges&Credits $9.48
Taxes,Governmental Surcharges&Fees $10.62
Total Current Charges $149.97
Verizon Wireless News.,
See Where You Use Data Total Charges Due by August 15, 2015 $124.91
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Pay from Wireless Pay
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Bill Date July 20, 2015 ,
Account Number 481004485-00001
Invoice Number 3276289240
RENEE KILPATRICK
2335 W 236TH ST Total Amount Due by August 15, 2015
SHERIDAN,IN 46069-8725
Make check payable to Verizon Wireless. $124.91
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Please return this remit slip with payment. $I i
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Scan To Pay Or Go Paperless
Pay your bill online,or enroll in Paperless Billing P.O.BOX 25505
or Auto Pay.Simply scan the OR code with your LEHIGH VALLEY, PA 18002-5505
mobile device or visit vzw.com/myverizon. o-
F1Check here and fill out the back of this slip if your billing address III'III'll'lllllil"'lll'I'llllllll'I'lllllllllllll'I'llllll"I'I
has changed or you are adding or changing your email address.
32762892400104810044850000100000014997000000124913
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
8/20/15 Reimb Cell phone charges Jul'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.
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#/TITLE 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 21, 2015
Signature
$ 25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund