215697 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 360464 Page 1 of 1
ONE CIVIC SQUARE LINDSAY LABAS
CARMEL, INDIANA 46032 8809147TH PLACE CHECK AMOUNT: $195.27
NOBLESVILLE IN 46060
CHECK NUMBER: 215697
CHECK DATE: 12/1812012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4359000 REIMB 47 . 64 SPECIAL PROJECTS
1091 4344100 REIMB 100 . 00 CELLULAR PHONE FEES
1091 4359000 REIMB 47 . 63 SPECIAL PROJECTS
Car-MCI • Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
a q 3`4141100 C 3 5 . oo I v`' o
1 c-)IIA VU q3"4q1C)o OtU4160MYU 0 - DO ✓ u Qom, � opl,
--l I a V -e-, 6�1 boll - 9 q -e n , g- oQVd vlho . Q IT
t l a- (0�'l ( - 9 9. o o �1-ot`/III
2� W1.0� 9 � tc,
All receipts should be attached in the same order as listed above. ---yy
No sales tax will be reimbursed. TOTAL: ��, aLT
=R1 Employee Name(print) �ndSa,(,� �Qs Address
Check
payable to: City, St, Zip O�eSV fj 1 f. IN L! U QU Q
Signature: .�_ - Approved by: _
Date: 49-1'g-o Z�� Date: Z-
Business Services Division,Revised 7-7-08
FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request
P.O.BOX 4002 Manage Your Account&View Your Usage Details Account Number Date Due
ACWORTH,GA 30101 ,w', wWW.vbrizonwir6Iess.com 986813753-00001
Address Changed?—go to vzw.com/changeaddress Invoice Number 2832405071
Quick Bill Summary Oct 21 -Nov 20
KEYLINE
/4606043313/
BENJAMIN LABAS Previous Balance (see back for details) $141.95
8809147TH PL Payment—Thank You —$141.95
NOBLESVILLE,IN 46060-4331 Balance Forward $.00
Monthly Access Charges $127.38
Verizon Wireless' Surcharges
and Other Charges&Credits $6.10
Taxes,Governmental Surcharges&Fees $6.84
Total Current Charges $140.32
Total Charges Due by December 15, 2012 $140.32
Pay from Wireless Pay on the Web Questions:
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VN
Bill Date GNo7vember_20,_2012
Account Number 986813753-00001
Invoice Number 2832405071
BENJAMIN LABAS Total Amount Due
8809 147TH PL
NOBLESVILLE,IN 46060-4331 deducted from bank account on 12/13/12
DO NOT MAIL PAYMENT $140.32
P.O.BOX 25505
LEHIGH VALLEY, PA 18002-5505
F-1 Check here and fill out the back of this slip if your billing address /1800255054/
has changed or you are adding or changing your email address.
2832405071010986813753000010000140320000140322
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.
360464 Labas, Lindsay Terms
8809 147th Place Date Due
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
12/20/12 Reimb Cell phone fees Nov'12 $ 50.00
12/20/12 Reimb Cell phone fees Dec'12 $ 50.00
12/20/12 _ Reimb_ _ Board video screening supplies $ 47.64
12/20/12 Reimb' Board video screening supplies $ 47.63
Total $ 195.27
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._
360464 Labas, Lindsay 'Allowed 20
8809 147th Place
Noblesville, IN 46060
In Sum of$
$ 195.27
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
d-
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1091 Reimb 4344100 $ 50.00 1 hereby certify that the attached invoice(s), or
1091 Reimb 4344100 $ 50.00 bill(s) is (are)true and correct and that the
1081-99 Reimb 4359000 $ 47.64 materials or services itemized thereon for
1091 Reimb 4359000 $ 47.63 which charge is made were ordered and
received except
13-Dec 2012
Signature
$ 195.27 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund