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212921 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 363878 Page 1 of 1 ONE CIVIC SQUARE SUSAN BEAURAIN CARMEL, INDIANA 46032 3737 KNICKERBOCKER PLACE 2 D CHECK AMOUNT: $50.00 INDPLS IN 46240 CHECK NUMBER: 212921 CHECK DATE: 9/25/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4344100 REIMB 50 . 00 CELLULAR PHONE FEES 0 Carmel lay Parks&Recreation Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense 9/10/2012 Sprint 1091 1 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 140 3rd Street N W 1 2012 i Check payable to: City, St, Zip Carmel, IN 46032 Signature: �o� Approved by: - Date: 9/10/2012 Date: Business Services Division,Revised 7-7-08 FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request 4/7/12 Sprint-Pay Bill-Credit Card Payment Confirmation Personal Business Ccrerage.maps DhkoverSprint inci a store Shopping Cart Sprint My Sprint Shop Digital Lounge Community Support sbeaurain Sign out (583570967) Pay Bill Imritto... SUSAN BEAURAIN Account nunber.583570967 Pay bill 6iroll in e8ill Thank you!Your Visa payment has been successfully submitted Sprint- and will be posted to your account within 15 minutes.Please Track called numbers print this page for your records. See adjustrrents and credits Payment Date: Sep 07,2012 See my bill Payment amount: $78.98 Card: See bill history Last 4 digits: See my order history Expiration date: 01/2013 See payment history ZIP code: 46032 Confirmation Number 041509 See rrry transaction hi5toiv Reduce the clutter,help the environment and go paperless with eBill.5ain uo now If you have questions,Rtease contact us via ein�il,or call us at(800)639.6111. Please pr in and keen a coov of tills bl1in,ccmfirmacior:fo'your files Become an insider About us Contact us En espanol Check out our nubile site Legal Privacy Ad choices ©2012 Sprint.com All rights reserved. Purchase Description P.O.# PoFj G.L.g# — � Line Desor Purchaser Date Approval Date https://myaccountportal.Sprintcom/ser\det/ecare 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 143 3rd Street NW Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 9/10/12 Reimb Cell phone fees Sep'12 $ 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 20 143 3rd Street NW Carmel, IN 46032 In Sum of$ $ 50.00 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. 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 20-Sep 2012 Signature $ 50.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund r P. 3,