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252688 12/15/15 CITY OF CARMEL, INDIANA VENDOR: 355319 ONE CIVIC SQUARE MICHAEL KLITZING CHECK AMOUNT: $**"*"***50.00* �. =a CARMEL, INDIANA 46032 1550 REDSUNSET DRIVE CHECK NUMBER: 252688 BROWNSBURG IN 46112 CHECK DATE: 12/15/15 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 Reimbursement for use of 11/12/2015 Verizon Wireless 101 1125-1-00-4344100 Cellular Phone Fees $50.00 personal phone for Department business DeG 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 I Address 1550 Redsunset Dr. f Check DEC — 7 2015 payable to: City, St, Zip Brownsburg, IN 46112 Signature: Approved by: Date: 12/4/2015 Date: Business Services Division,Revised 7-7-08 FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request i s � I' veru Manage Your Account Account Number Date Due P.O.BOX 4002 ACWORTH,GA 30101 t: °° 9 9 6 0 1 Change your address at Invoice Number 3326466799 vzw.com/changeaddress 0259817 01 AT 0.413 ""AUTO TO 0 4712 46112-773450 -C07-P60096-11 Quick Bill Summary Oct 13—Nov 12 III"I'IIII'llllll'llllll�l l��lll��llllllll'I'I"II'lll'lll'I'I' MICHAEL W KLITZING Previous Balance (see back for details) $108.86 1550 REDSUNSET DR Payment—Thank You —$108.86 BROWNSBURG,IN 46112-7734 Balance Forward $.00 Monthly Charges $73.99 Usage and Purchase Charges Voice $.00 -Messaging Data $.00 Equipment Charges $27.08 Verizon Wireless'Surcharges Verizon Wireless News and Other Charges&Credits $3.53 Watch Next Week's Game From Taxes,Governmental Surcharges&Fees $4.26 The Comfort Of Your Total Current Charges $108.86 Smartphone. NFL Mobile is now included with all Verizon plans.Now everyone can watch Total Charges Due by December 07, 2015 $108.86 live local and primetime games.For more details about NFL Mobile,visit vzw.com/nfl. Get the latest deals on THE LATEST ACCESSORIES. Visitgo.vzw.com/deals Pay from Wireless Pay on the Web Questions. VN w ® i ,#--,- v/ Bill Date November 12, 2015 Account Number 480873963-00001 aa0 Invoice Number 3326466799 Please Recycle MICHAEL W KLITZING 1550 REDSUNSET DR Total Amount Due by December 07, 2015 BROWNSBURG,IN 46112-7734 Make check payable to Verizon Wireless. $108.86 �®Qv.�c `7 Please return this remit slip with payment. � . OF ❑ . El❑ Scan To Pay Or Go Paperless Pay your bill online,or enroll in Paperless Billing 5 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- ❑ Check here and fill out the back of this slip if your billing address IIIII"I'lllll'I'I'III"II''llllllll'llll'll'lllll"'11111"11111 has changed or you are adding or changing your email address. 33264667990104808739630000100000010886000000108868 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. verizonNI Invoice Number Account Number Date Due Page -3 _ =667 99 963=0,1 1 ti07/,15 `. a Get Minutes Used Get Data Used Get Balance 1 1' 1 C' 1 Explanation of Charges Payments Verizon Wireless'Surcharges Previous Balance $108.86 Verizon Wireless' Surcharges include (i) a Regulatory Charge (which helps defray various government charges we pay including Payment—Thank You ® government number administration and license fees); (ii) a Payment Received 11/06/15 —108.86 ® Federal Universal Service Charge (and, if applicable, a State ® Universal Service Charge)to recover charges imposed on us by Total Payments —$108.86 the government to support universal service; and (iii) an Balance Forward $.00 ® Administrative Charge, which helps defray certain expenses we incur, including: charges we, or our agents, pay local telephone companies for delivering calls from our customers to their customers; fees and assessments on our network facilities and services; property taxes; and the costs we incur responding to ® regulatory obligations. Please note that these are Verizon Wireless charges,not taxes.These charges,and what's included, ® are subject to change from time to time. Taxes,Governmental Surcharges and Fees Includes sales, excise and other taxes and governmental surcharges and fees that we are required by law to bill customers. These taxes, surcharges and fees may change from time to time without notice. Late Fee Information A late payment applies for unpaid balances.The charge is the greater of$5 or 1.5%per month,or as permitted by law. Verizon Wireless'Other Charges and Credits Includes charges for products and services,and credits owing. >?.x:".. ,.,.-, res, — ;"+:x';,, ..�.•:._ ":i." 'r�.; .Vm`rr.>- a »�' -,:_- :fx.;,°�;ggaro•�• -.,?:-- +. :6�-- "ei 'i ;, - Correspondence3Address:zVeriion Wheless Attn..Correspondence.Team PO Box�5029 Wallingford;CT.06492 e ;.;,,, :. z .. >;�X- a--,> std. Automatic Payment Enrollment for Account:480873963-00001 MICHAEL W KLITZING By signing below,you authorize Verizon Wireless to electronically debit your bank account each month for the total balance due on your account.The check you send will be used to setup Automatic Payment. You will be notified each month of the dale and amount of the debit 10 days in advance of the payment. I understand and accept these terms. This agreement does not alter the terms of your existing Customer Agreement.I agree that Verizon Wireless is not liable for erroneous bill statements or incorrect debits to my account.To withdraw your authorization you must call Verizon Wireless.Check with your bank for any.charges. 1.Check this box. 2.Sign name in box below,as shown on the bill and date. 3.Return this slip with your payment.Do not send a voided check. NAM Changing your billing address for Account:480873963-00001 MICHAEL W KLITZING Use this space or sign in to My Verizon at vzw.com/changeaddress to change the mailing address where we send your bill.If we do not have your most recent email address,provide it below and we'll use it to tell you important information about your Verizon Wireless service.Allow 2 billing cycles for the address change to take effect. New Address Confirming or changing your service address For each of your mobile numbers,in order to bill taxes and City surcharges correctly we need a service address-which is a street address(not a PO Box)that is the home or primary State/Zipbusiness address of the person who uses that number.To Work Phone Home Phone confirm or,change the service address for any of your mobile numbers,sign in to My Verizon at vzw.com/serviceaddress. Email 0259817-0968671-0000002 of 0000004-C07-LT-4712-60096 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 11/12/15 Reimb Cell phone Dec'15 $ 50.00- Total 0.00.-Total $ 50.00 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 I 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 December 8, 2015 'PAM"VAU) Signature $ 50.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund