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206318 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 355319 Page 1 of 1 ONE CIVIC SQUARE MICHAEL KLITZING CARMEL, INDIANA 46032 1550 REDSUNSET DRIVE CHECK AMOUNT: $61.27 BROWNSBURG IN 46112 CHECK NUMBER: 206318 4 iio i o. CHECK DATE: 2/14/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4346000 REIMB 61.27 CLASSIFIED ADVERTISIN P, Carme e Clay Parks &Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt Line Budget Description Amount Purpose of Expense 1/21/2012 Facebook.com 108 1081 -99- 4346000 Classified Advertisements $21.31 ESE Facilitator job advertisement 1/27/2012 Facebook.com 108 1081 -99- 4346000 Classified Advertisements $19.15 ESE Facilitator job advertisement 2/2/2012 Facebook.com 108 1081 -99- 4346000 Classified Advertisements $20.81 ESE Facilitator job advertisement All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: $61.27 Employee Name (print) Michael Klitzing D Address 1550 Redsunset Dr. F EB 0 8 2012 Check payable to: City, St, Zip Brownsburg, IN 46112 Signature: Approved by: Date: Z�$ rl L Date: Business Services Division, Revised 7 -7 -08 FILE: Shared\Administrative \Forms \Staff Forms \Employee Exp Reimb Request 2/8/12 American Express US: Manage Your Card Account: Online Statement Transaction Date: 01/21/2012 Sat Transaction Description: FACEBOOK .COM"TVQM322WWW.FB.ME /CC CA FACEBOOK ADVERTISING Amount 21.31 Doing Business As: FACEBOOK ADVERTISING Merchant Address: 1601 CALIFORNIA AVE PALO ALTO CA 94304 UNITED STATES E Reference Number: 320120210437025853 Category: Business Services Advertising Services )s:// online. americanexpress. com /myca /estmt/us /Iist.do ?req uest_ type =a... 1/1 2/8/12 American Express US: Manage Your Card Account: Online Statement Transaction Date: 01/27/2012 Fri Transaction Description: FACEBOOK .COM*DG6N322WWW.FB.ME /CC CA FA CEBOOK ADVERTISING i Amount 19.15 Doing Business As: FACEBOOK ADVERTISING Merchant Address: 1601 CALIFORNIA AVE PALO ALTO CA 94304 UNITED STATES Reference Number: 320120270004183844 Category: Business Services Advertising Services )ttps: online. americanexpress. com /myca /estmUus /list.do ?request type =a... 1 /1 2/8/12 American Express US: Manage Your Card Account: Online Statement Transaction Date: 02/02/2012 Thu j Transaction Description: FACEBOOK .COM*E8NN322WWW.FB.MEJCC CA I 97728111914 FACEBOOK ADVERTISING FACEBOOK ADVERTISING Amount 20.81 Doing Business As: FACEBOOK A DV ERTIS ING Merchant Address: 1601 CALIFORNIA AVE PALO ALTO CA 94304 UNITED STATES E Reference Number: 320120330075987618 Category: Business Services Advertising Services https: online. americanexpress. com /myca /estmt/us /list.do ?request type =a... 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. 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 2/8/12 Reimb ESE Facilitator job advertisement 61.27 Total 61.27 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 61.27 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members Dept 1081 -99 Reimb 4346000 61.27 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 -Feb 2012 Signature 61.27 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund