328934 08/17/18 \• CITY OF CARMEL, INDIANA VENDOR: 365288
ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $********50.00*
'a CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD CHECK NUMBER: 328934
WESTFIELD IN 46074 CHECK DATE: 08/17/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50.00 CELLULAR PHONE FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 365288 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Baumgartner, Kurtis Payee
16930 Kingsbridge Blvd
Westfield, IN 46074 In Sum of$ Purchase Order#
365288 Baumgartner, Kurtis Terms
$ 50.00 16930 Kingsbridge Blvd Date Due
Westfield, IN 46074
ON ACCOUNT OF APPROPRIATION FOR
109-Monon Center
PO#ornvolce Description
Dept# INVOICE N0. ACCT#!TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1091 Reimb 4344100 $ 50.00 Board Members 8/14/18 Reimb Cell Phone Reimbursement Jul'18 $ 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
$ 50.00 Total $ 50.00
August 15,2018
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
Cost distribution ledger classification if
claim paid motor vehicle highway fund Signature -,20_
Accounts Payable Coordinator Clerk-Treasurer
Title
Carmel * Clay
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
8/13/2018 AT&T 1091 4344100 Cellular Fees $ 50.00 July Cell Reimbursement
-T
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name(print) urns-Baumaart� RECEIVED
Address 1-6930_Iings ridge Blvd.
AUG 1 0 2010
Check --
payable to: City, St, Zip
Wes bld;IN-460.7� y:..............................
Signature: Approved by:
Date: F-8 :4/2018:� ,:. Date:
EW/
�I�
�1- --� - -
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request