250584 10/21/15 o;,
CITY OF CARMEL, INDIANA VENDOR: 365288
"I ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $********50.00*
CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD CHECK NUMBER: 250584
WESTFIELDIN 46074 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50.00 CELLULAR PHONE FEES
DUE BY: Oct 15,2015 $112.37
KURTIS BAUMGARTNER
Account Number 243007377604 ES IELD,I 4607IDGE BLVD
a}�} WESTFIELD,IN 46074-7800
` ` Please include account number on your check.
Make checks payable to:
CHECK FOR AUTO PAY AT&T MOBILITY
(SEE REVERSE) PO BOX 6416
CAROL STREAM IL 60197-6416
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974002430073776040000000001123700000011237009
9175.8.336.69969 2 AV 0.391 6n AutoPay Enrollment
If I enroll in AutoPay,I authorize AT&T to pay my bill monthly
"Il�i�ll"'II' 'II�I��II'�IIIIII�'�'ll�'ll�lll'�II�II�III��IIII by electronically deducting money from my bank account.I can
cancel authorization by notifying AT&T at www.att.com or by
KURTIS BAUMGARTNER calling the customer care number listed on my bill.Your
16930 KINGSBRIDGE BLVD enrollment could take 1-2 bitting cycles for AutoPay to take
WESTFIELD IN 46074-7800 effect. Continue to submit payment until page one of your invoice
reflects either AutoPay will Debit Your Bank Account by or
AutoPay will Debit Your Credit Card by.
Bank Account Holder Signature:
Date:
Carmel 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
10/15/2015 AT&T 1091 4344100 Cellular Phone Fees $ 50.00 September Cell Reimbursement
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $50.00
Employee Name(print) Kurtis Baumgartner
Check Address 16930 Kingsbridge Blvd
payable to: City, St, Zip Westfield, IN 46074
Signature' Approved by:
Date: 10/6/2015 Date:
Business Services Division,Revised 7-7-0801 ' --
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request 1
OCT 12 2015
BY: __ I
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
10/6/15 Reimb Cell phone Sep'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
20`
Clerk-Treasurer
I S Y: rZ�t 4't'iJ
Voucher No.
1� Wei rr;iri�
365288 Baumgartner, Kurtis
16930 Kingsbridge BIvi1 Allowed
Westfield, IN 46074 ' 20
In Sum of$
$ 50.00
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or
Dept# INVOICE NO. CCT#/TITL
AMOUNT Board Members
1091 Reimb 434.4100 r
$ 50.00 I 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
October 12, 2015
_ $ 50.00 Signature
Cost distribution ledger clisslfiration if Accounts Payable Coordinator
way fund
claim paid motor vehicle highTiffe