205398 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 363878 Page 1 of 1
0 ONE CIVIC SQUARE SUSAN BEAURAIN
CARMEL, INDIANA 46032 3737 KNICKERBOCKER PLACE 2 D CHECK AMOUNT: $50.00
INDPLS IN 46240
CHECK NUMBER: 205398
CHECK DATE: 1117/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50.00 CELLULAR PHONE FEES
Carmel a Clay
Parks Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense
5
12/16/2011 Sprint 1091 4344100 Cellular Phone Fees 50.00 Personal Cell Phone Use
i
December
I
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 140 3rd Street NW
Check
payable to: City, St, Zip Carmel, IN 46032
Signatur Approved by: A7
Date: 12/16/2011 Date: i
rr l�� ,i V jll Business Services Division, Revised 7 -7 -08 f1 FILE: Shared�Administrative\Forms \Staff Forms\Employee Exp Reimb Request DEC 1. 9 201
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SUSAN BEAURA114
Account number: 583570967 Pay bill
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Payment Date: Dec 16, 2011 See my bill
Payment amount: $78.52
Card: Visa See bill history
Last 4 digits: 6283 See my order history
Expiration date: 0112013
ZIP code: 46032 See payment history
Confirmation Number 022215 See my transaction
history
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Purchase
Description �.7✓ V t7 601 Ivy J
P.O. P DO
G.L. Q) C)
Lichee
Line Descr
Purchaser Dat
Approval Date
fl
12/ 16/2011 1-?? PTu
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
143 3rd Street NW
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12116111 Reimb Cell phone use Dec'11 50.00
Total 50.00
I 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
143 3rd Street NW
Carmel, IN 46032 bl In Sum of
50.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #rTITLE 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
11 -Jan 2012
ea�,JT"&�
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I