197561 05/26/2011 CITY OF CARMEL, INDIANA VENDOR: 363878 Page 1 of 1
ONE CIVIC SQUARE SUSAN BEAURAIN
3737 KNICKERBOCKER PLACE 2 D CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032
INDPLS IN 46240 CHECK NUMBER: 197561
CHECK DATE: 5/2612011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50.00 CELLULAR PHONE FEES
Carmel o Clay
Parks &Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
4/28/2011 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 I �A MA Address 3737 Knickerbocker Place 4
Check
payable to: City, St, Zip rN Indianapolis, IN 46240 Y:
Signature: Approved by:
Date: 5/2/2011 Date: y
Business Services Division, Revised 7 -7 -08
FILE: Shared \Administralive%Formslstaff Forms%Employee Exp Reimb Request
4/28/2011 Payment Confirmation
c
Payment Confirmation
Account Owner: SUSAN BEAURAIN
Account Number: 243001754139
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Thank you for your payment. Please print CURRENT PAYMENT CHARGES
or save a copy of this confirmation for your Last Payment Received (04- 28 -11)
records.
Updated Account Balance $0.00
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Credit /Debit Card Information
Confirmation number QPCOAT665889477
Amount $143.55
Date 04/28/2011
Method r
Card type
Card number xxxxxxxxxx
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Purchase
Description
P.O. P
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Budget k �n
Line Des
Purchaser Date
Approval ate S
att.com /pmt /submitQuickConfirm.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
4/28/11 Reimb Cell phone reimbursement 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 N0. ACCT #/TITLE 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
19 -May 2011
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund