HomeMy WebLinkAbout253826 01/26/16 CITY OF CARMEL, INDIANA VENDOR: 365288
® ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $*"'•"•80 59•
?� CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD CHECK NUMBER: 253826
WESTFIELD IN 46074 CHECK DATE: 01/26/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4343000 REIMB 80.59 TRAVEL FEES & EXPENSE
PI-EC ETV 7E.-I V-3
Carmel o Clay JAN 18 2016
Parks&Recreatioh BY:
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
1/13/2016 Motherbears Pizza 1091 4343000 Travel Fees&Expenses $ 80.59 IPRA Dinner-Participants
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $80.591
Employee Name(print) Kurtis Baumgartner
Address 16930 Kingsbridge Blvd
Check
payable to: City, St, Zip -Westfield, IN 46074
Signature: Approved by:
I Date: 1/13/2016 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
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
1/13/16 Reimb Travel Expenses for IPRA Dinner- Participants $ 80.59
Cell phone Dec'15
Total $ 80.59
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$
$ 80.59
I
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. A.CCT#TTITLE AMOUNT Board Members
Dept#
1091 Reimb 4343000 $ 80.59 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
January 18, 2016
i
Signature
$ 80.59 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund