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Home My WebLink About211833 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 355319 Page 1 of 1 ONE CIVIC SQUARE MICHAEL KLITZING CHECK AMOUNT: $407.00 CARMEL, INDIANA 46032 1550 REDSUNSET DRIVE BROWNSBURG IN 46112 CHECK NUMBER: 211833 CHECK DATE: 8/14/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4358300 REIMB 250 . 00 OTHER FEES & LICENSES 1125 4355200 REIMB 157 . 00 SUBSCRIPTIONS 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 Digital waivers;monthly unlimited 7/23/2012 SmartWaiver 109 1094-4358300 Other Fees & Licenses $250.00 service plan Online employee scheduling 7/26/2012 When to Work 101 100-000-4355200 Subscriptions $157.00 service(7/27/12-8/26/12) All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: $407.00 Employee Name (print) Michael Klitzing F _ , T-/ Address 1550 Redsunset Dr. Check JUL 31 212 payable to: City, St, Zip Brownsburg, IN 46112 Signature: Approved by: Date: '7�z81� .� Date: Business Services Division,Revised 7-7-08 FILE: SharedWdministrative\Forms\Staff Forms\Employee Exp Reimb Request Michael Klitzing From: AutoForward @mail5.WhenToWork.com on behalf of WhenToWork-corn [billing @mail5.WhenToWork.com] Sent: Thursday, July 26, 2012 3:06 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 $157 for a recurring monthly subscription on your WhenToWork Carmel Clay Parks & Recreation account # 21996201 for a total of up to 350 employees. (Your account is currently at 398 employees. ) Your account is now paid through Aug 26, 2012. (You can stop your automatic renewal using the Settings / Make A Payment page.) Please contact us if you have any suggestions or comments about our system. Thanks for choosing WhenToWork. Sarah billingpWhen2Work.com and the staff at: https://WhenToWork.com 1 Michael Klitzing From: mark=smartwaiver.com @chargify.com on behalf of mark @smartwaiver.com Sent: Wednesday, July 25, 2012 8:47 PM To: Michael Klitzing Subject: Receipt for your purchase of Unlimited Waiver Service Plan (1 location) Dear Michael You were just charged $250.00 for Unlimited Waiver Service Plan (1 location) . Cheers, Christina Brummond christinapsmartwaiver.com 800-277-0285 x701 1 https://oniine.americanexpress.com/myca/estmt/us/print—doc.htmI Transaction Date: 07/23/2012 Mon 1.1.1--.-..... .... __ _ ................ Transaction Description: SmartWaiver 541-516-0174 85180892206541-516-0174 541-516-0174 Amount$: 250.00 __...... . ....... ........- ....... ................... . Doing Business As: SMARTWAIVER ........ _._............ ............._........ _..__.... ............. ................_ Merchant Address: 2964 NW TERRA MEADOW DR BEND OR 97701 UNITED STATES ..... ........ _. __. ......... _.. _ __. ............ ......._ Reference Number: 320122060247779437 Category: Other-Miscellaneous 1 of 1 7/26/2012 9:09 AM 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 7/23/12 Reimb Digital waivers service plan $ 250.00 7/26/12 Reimb Online employee scheduling 7/27 -8/26/12 $ 157.00 Total $ 407.00 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$ $ 407.00 ON ACCOUNT OF APPROPRIATION FOR 101 -General Fund / 109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 Reimb 4358300 $ 250.00 1 hereby certify that the attached invoice(s), or 1125 Reimb 4355200 $ 157.00 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-Aug 2012 Signature $ 407.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund