319738 12/15/17 4. CITY OF CARMEL, INDIANA VENDOR: 368259
ONE CIVIC SQUARE SHAUNA LEWALLEN CHECK AMOUNT: $...*****23.41
CARMEL, INDIANA 46032 15066 REDCLIFF DRIVE CHECK NUMBER: 319738
9 irdN-�o� NOBLESVILLE IN 46062 CHECK DATE: 12/15/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 23.41 CELLULAR PHONE FEES
Voucher No. Warrant No.
368259 Lewallen, Shauna Allowed 20
15066 Redcliff Drive
Noblesville, IN 46062
In Sum of$
$ 23.41
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center.
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1091 Reimb 4344100 $ 23.41 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, 2017
1P
Signature
$ 23.41 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Carmel ay
DEC 0 6 2011
Parks&Recreation ��..............
Employee Expense Reimbursement Request
Date of Fund ,Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
11/25/2017 Republic Wireless 1091 4344100 Cellular Phone Fees $23.41 Cell phone charges November
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: ,,__ _ ✓$23:99F
Employee Name(print)
"
> t-�'Shauna`Lewa_Ilen�-_'_.
Address _ ��=5066tRecictiff�Dri�e,�
Check
payable to: City, St, ZipNoplesvilfeIN_:4:60,62.
Signature: ( , ��aArn Approved by: ,
Date: .= '1P2%5y20=17_ Date:
T t
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
Print Orders &Payments I Republic Wireless Page 1 of]
Nov 25, 2017 4:14 nM Invoice Total
Invoice
$23.41
. ..---.. . ......I-- ........... .1.1.1.1-1-...... _ .. ...... ... _ . ....... ..... .... .. .
Phone Service 4-INV13349716
(317) 427-5511 Clear Choice Talk & Text $18.41
Moto G 'LUS 1 h Gen.,(,vi,Ete IN Universal Service C hergc-S
Tsai S .. gate $0.03
354113071 1.1«34
Sales Tax-State $1.13
Fed USF Cellular- ederal $1.05
Federal Con;pliance Fee-Federal $0.12
E911(wireless;-State $1.00
Telecom Relay Surcharge...State $0.03
Clear Choice Data $5.00
Sub Total $23.41
........................ ......... . ....... .
Grand Total $23.41
Billing Address:
Shauna R Lewallen Credit Card:
15066 Redcliff Dr ************6334
Noblesville,Indiana 46062-7107 6/2019
re u b I i
1 W I R F. L E 5 5
republicwire':ess.com
help;_xrepublicwircless.com Z!7.
JD
Venture center I DEC
Suite 300
940 Mair;Campus Drive
Raleigh,NC 27606
https://republiewireless.com/account/invoices/print/?invoice=2c92a0995fe26904015ff274e9a90f3c 12/4/201;