190667 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 363878 Page 1 of 1
ONE CIVIC SQUARE SUSAN BEAURAIN
CARMEL, INDIANA 46032 3737 KNICKERBOCKER PLACE 2 D
INDPLS IN 46240 CHECK AMOUNT: $50.00
CHECK NUMBER: 190667
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 50.00 CELLULAR PHONE FEES
Carm Clay
Parks &recreation
Employee Expense Reimbursement Request
Date of Fund Account Account.
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
9/8/2010 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 safes tax will be reimbursed. TOTAL: $50.00
Employee Name (print) Susan Beaurain
Address 3737 Knickerbocker Place
Check
payable to: City, St, Zip Indianapolis, IN 46240
Signature: Approved by:
Date: 9/27/2010 Date:
Business Services Division, Revised 7 -7 -08 D
FILE: Shared\AdministrativelForms \Staff Forms \Employee Exp Reimb Request C p 2010
9 ,2'2) BY:.....
"lit 1 1 Page 1 of 20
a w Prin, Print Preview Download PDF Close
Statement Date 08109!10 09!08110
How to Contact Us:
Account Number: 243001754139 1- 800 331 -0500 or 611 from your cell phone Previous Balance 134.94
For Deaf /Hard of Hearing Customers (TTY/TDD) Payment Posted 134.94
BALANCE 0.00
1 -866- 241 -6567 Monthly Service Charges 119.99
Usage Charges 0.00
Credits/Adjustments/Other Charges 5.25
Government Fees Taxes 7.15
Wireless Number TOTAL CURRENT CHARGES 132.39
317 730 -4150 Due Oct 03, 2010
Late fees assessed after Oct 08
Total Amount Due $132.39
Add a Line with Family Talk from AT&T
FamilyTalk(R) plans start at just $69.99 /month including
700 Rollover Minutes. Add up to three additional lines
for only $9.99 each. Sign up now by calling 800 -449 -1672
or visit ATT.COM /ADDALINE
Return the portion below with payment
Purchase onl to AT &T Mobility.
y
P.O. 0. P F Account Number: 243001754139
G.L. g et L21. q �L Total Amount Due $132.39
Bud
Line Descr`2LO' i Qh�Q S Amount Paid:
Purchaser Date
Approval Dat Please do not send correspondence with payment.
SUSAN BEAURAIN Yes, enroll me in AutoPay
Signature required on reverse
3737 KNICKERBOCKER PL
INDIANAPOLIS, IN 46240 -7609 Total Amount Due
Oct 03, 2010
Please Mail Check Payable To:
AT &T Mobility
PO Box 6416
Carol Stream, IL 60197 -6416
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, MD, M E 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
https:// www. att.cOm/View /displayPul1Bili.do
9/27/2010
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 invoice(s) or bill(s)) PO Amount
918110 Reimb Cell phone reimbursement Sep'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
7 -Oct 2010
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund