192667 12/10/2010 CITY OF CARMEL, INDIANA VENDOR: 355319 Page 1 of 1
,4 0 ONE CIVIC SQUARE MICHAEL KLITZING CHECK AMOUNT: 5180.00
CARMEL, INDIANA 46032 1550 REDSUNSET DRIVE
BROWNSBURG IN 46112 CHECK NUMBER: 192667
CHECK DATE: 12110/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4355200 180.00 SUBSCRIPTIONS
Carmel
Parks &Recreation
Employee Expense Reimbursement Request
Date of 'Fund Account Account
Receipt Vendor listed on receipt Line Budget Descrip Amount Purpose of Expense
Online employee scheduling
11/26/2010 When to Work 101 100-000-4355200 Subscriptions $180.00 service (11/27/10- 12/26/10)
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL. $180.00
Employee Name (print) Michael Klitzin
Address 1550 Redsunset Dr.
Check
payable to: City, St, Zip Brownsburg, IN 46112
X V
Signature: Approved by:
g
Date: I i ;30 J Date:
Business Services Division, Revised 7 -7 -08
FILE: SharedlAdministrative %Forms\Staff Forms\Employee Exp Reimb Request
Michael Klitzing
From: AutoForward @mail5.WhenToWork.com on behalf of WhenToWork.com
[billing @mail5.WhenToWork.com]
Sent: Friday, November 26, 2010 3:05 AM
To: Michael Klitzing
Subject: Your WhenToWork renewal has been processed
Dear Michael Klitzing,
Your WhenToWork.com automatic monthly renewal has been processed.
Your credit card has been billed $180 for a recurring monthly subscription on your WhenToWork Carmel Clay Parks
Recreation account 21996201 for a total of up to 400 employees.
(Your account is currently at 271 employees.)
Your account is now paid through Dec 26, 2010.
(You can stop your automatic renewal using the Settings Make A Payment }gage.)
Please contact us if you have any suggestions or comments about our system.
Thanks for choosing WhenToWork.
Sarah
billing@When2Work.com
and the staff at:
https: /WhenToWork.com
1
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.
355319 Klitzing, Michael Terms
1550 Redsunset Dr Date Due
Brownsburg, IN 46112
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/30/10 Reimb Online employee scheduling 11/27 12/26/10 180.00
Total 180.00
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
i
Voucher No. Warrant No.
355319 Klitzing, Michael Allowed 20
1550 Redsunset Dr
Brownsburg, IN 46112
In Sum of
180.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Reimb 4355200 180.00 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
9 -Dec 2010
Signature
180.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund