HomeMy WebLinkAbout189683 09/14/2010 a CITY OF CARMEL, INDIANA VENDOR: 363878 Page 1 of 1
ONE CIVIC SQUARE SUSAN BEAURAIN
i 0 CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032 3737 KNICKERBOCKER PLACE 2 D
INDPLS IN 46240 CHECK NUMBER: 189683
CHECK DATE: 9/1412010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 50.00 CELLULAR PHONE FEES
Car Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
7/8/2010 AT &T 1091 4344100 Cellular Phone Fees 50.00 Personal Cell Phone Use
All receipts should be attached in the same order as listed above.
No sales tax will be re TO TAL: $50.00
Employee Name (print) Susan Beaurain
Address 3737 Knickerbocker Place
Check
payable to: City, St, Zip Indianapolis, IN 46240
Signature- Approved by:
Date: 8/13/2010 Date: Z.3
Business Services Division, Revised 7 -7 -08 D L/
FILE: SharedlAdministrative \Forms\StafF Forms\Employee Exp Reimb Request AUG 9 20
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Statement Date 06/09110 07108/10
How to Contact Us:
Account Number: 243001754139
Previous Balance 135.33
1- 800 -331 -0500 or 611 from your cell phone Payment Posted
For Deaf /Hard of Hearing Customers (TTY/TDD) 135.33
BALANCE 0.00
1 -866- 241 -6567 Monthly Service Charges 119.99
Usage Charges 7 0.00
Credits/Adjustments/Other Charges 5.67
Government Fees Taxes 9
Wireless Number TOTAL CURRENT CHARGES 134.94
317- 730 -4150 Due Aug 03, 2010
Late fees assessed after Aug 08
Total Amount Due $134.94
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Return the portion below with payment
only to AT&T Mobility.
Account Number: 243001754139
Total Amount Due $134.94
Amount Paid:
Please do not send correspondence with payment.
Yes, enroll me in AutoPay
SUSAN BEAURAIN Signature required on reverse
3737 KNICKERBOCKER PL
INDIANAPOLIS, IN 46240 -7609 Total Amount Due
Purchase Aug 03, zola
Description 1 1
P.O.0" Po Please Mail Check Payable To:
G.L. 0 L i:j a0
Budg AT &T Mobility
Line Desa u 0\l PO Box 6416
Purchaser Date tl6 Carol Stream, IL 60197 -6416
Approval Date tc
General Information
Late fee: Accounts with former AT &T Wireless plans are charged 1.5% or less of the balance
unpaid as of the next bill period. Accounts with Cingular /new AT &T plans are charged $5 in CT.
DC, DE, IL, KS, MA, M D ME MI, MO, NH ,NJ,NY,PA,OK,OH,RI,VA,VT,WI,WV; or 1.5% of the
balance unpaid as of the next bill period in all other states. Accounts with former AT &T
htt /w ww.att.coni/ pmt/ jsp/ mypayment /viewbill /viewFuIIBIII jsp ?report Act 1onEvent =A 7/30/2010
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.
363878 Beaurain, Susan Terms
3737 Knickerbocker place Apt 2D
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) PO Amount
7/8110 Reimb Cell phone reimbursement Jul'10 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
Voucher No. Warrant No.
363878 Beaurain, Susan Allowed 20
3737 Knickerbocker place Apt 2D
Indianapolis, IN 46240
In Sum of
50.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1091 Reimb 4344100 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
9 -Sep 2010
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund