250129 10/07/15 ,'� CITY OF CARMEL, INDIANA VENDOR: 365288
® i. - ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $*******125.41*
��; CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD CHECK NUMBER: 250129
.y��roN ca, WESTFIELD IN 46074 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4343000 125.41 TRAVEL FEES & EXPENSE
+Carrel 0 !_ay
Parks&Recreation
Employee Expense Reimbursement Request.
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
9/14/2015 Shake Shack 1091 4343000 Travel Expense $ Qc 5.68 Food Reimbursement
9/15/2015 Starbucks .1091 4343000 Travel Expense $ 6.22 Food Reimbursement
9/16/2015 Starbucks 1091 4343000 Travel Expense $ fG 6.22 Food Reimbursement
9/16/2015 Double Barrel 1091 4343000 Travel Expense $ J 18.00 Food Reimbursement
9/16/2015 Shake Shack 1091 4343000 Travel Expense $ 16.15 Food Reimbursement
9/17/2015 Starbucks 1091 4343000 Travel Expense $ 6.76 Food Reimbursement
9/17/2015 Nathan's Famous 1091 4343000 Travel Expense $ 12.19 Food Reimbursement
9/17/2015 Verifone Transportation System 1091 1 4343000 Travel Expense $ -A 18.19 Transportation to Airport
9/17/2015 Indianapolis International Airport 1 1091 4343000--1 Travel Expense $ 36.00 Parking
2-0 I'S
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $125.41
Employee Name(print) Kurtis Baumgartner C� l�
Address 16930 Kingsbridge Blvd
Check
payable to: City, St, Zip Westfield, IN 46074 {�
_ Approved b f
Signature: pp :y
Date: 9/18/2015 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
SEP 2 22015
7]B`Y:
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.
365288 Baumgartner, Kurtis Terms
16930 Kingsbridge Blvd
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
9/18/15 Reimb Travel expenses for NRPA Conference $ 125.41
Total $ 125.41
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.
365288 Baumgartner, Kurtis +. Allowed 20
16930 Kingsbridge Blvd
Westfield, IN 46074
In Sum of$
i.
$ 125.41
I
r
I
ON ACCOUNT OF APPROPRIATION FOR
i,
109 -Monon Center 44
PO#or INVOICE NO. CCTXTITL AMOUNT Board Members
Dept#
1091 Reimb 4343000 $ 125.41 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
which charge is made were ordered and
�+ received except
October 1,2015
'P i'
Signature
$ 125.41 (, Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund j