215968 01/09/2013 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: $100.00
INDPLS IN 46240 CHECK NUMBER: 215968
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 100 . 00 CELLULAR PHONE FEES
Cal-Mel y
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
12/15/2012 Sprint 1091 4344100 Cellular Phone Fees $ 50.00 Novemeber cell phone
12/15/2012 Sprint 1091 4344100 Cellular Phone Fees $ 50.00 December cell phone
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $100.00
Employee Name(print) Susan Beaurain
Address 140 3rd St NW
Check
payable to: City, St, Zip Carmel, IN 46032
Signature: Approved by: -
Date: t24 i'Z 11 2- Date: I Z' �l L
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
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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
12/17/12 Reimb Cell phone charges Nov,Dec'12 $ 100.00
Total $ 100.00
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$
$ 100.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1091 Reimb 4344100 $ 100.00 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
3-Jan 2013
Signature
$ 100.00 Accounts_Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund