195340 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 363878 Page 1 of 1
ONE CIVIC SQUARE SUSAN BEAURAIN
O I CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032 3737 KNCKERBOCKER PLACE 2 D
INDPLS IN 46240 CHECK NUMBER: 195340
CHECK DATE: 3/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE N UMBER AMOUNT DESCRIPTION
1091 4344100 50.00 CELLULAR PHONE FEES
Carmel Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
2/7/2011 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 reimbursed. TOTAL: $50.00
Employee Name (print) Susan Beaurain
Address 3737 Knickerbocker Place
Check
payable to: City, St, Zip Indianapolis, IN 46240
Signatur Approved by:
Date: 2/17/2011 Date:
Business Services Division, Revised 7 -7 -08 Q p� l7
FILE: Shared \Administrative\Forms\Staff Forms\Employee Exp Reimb Request
FEB 1 2 011 �f
BY
2/17/2011 Payment History
at&t
Payment History
A ccount Owner: SUSAN BEAURAIN
Account Number: 243001754139
V iew Account Profile
Review all payments made to this account CURRENT PAYMENT CHARGES
by date or amount. Last Payment Received (02- 07 -11) $150.58
Total Amount Due $143.71
Payment Due: 0310312011
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Previous Payments
DATE POSTED PAYMENTMETHOD AMOUNT
02/07/2011 CREDIT CARD *6283 ($150.58)
01/06 /2011 CREDIT CARD *6283 ($132.23)
12/03/2010 CREDIT CARD *6283 ($132.23)
10/23/2010 CREDIT CARD *6283 ($132.23)
09/24/2010 CREDIT CARD *6283 ($132.39)
08/31/2010 CREDIT CARD *6283 ($134.94)
07/30/2010 CREDIT CARD *6283 ($134.94)
07/02/2010 CREDIT CARD *6283 ($135.33)
05/24/2010 CREDIT CARD *6283 ($135.33)
04/23/2010 CREDIT CARD *6283 A ($135.33)
03/26/2010 CREDIT CARD *6283 ($168.90)
02/26/2010 CREDIT CARD *6283 ($198.54)
Purchase
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Purchaser y 1/ e r Date
Approval Date
www.att.com /pmt /displayHistoryPage.do 1/1
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.
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
2/7/11 Reimb Cell phone reimbursement 50.00
Total 50.00
f 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. 4CCT #1TITLE AMOUNT Board Members
Dept
1091 Reimb 4344100 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
10 -Mar 2011
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund