217957 03/13/2013 CITY OF CARMEL, INDIANA VENDOR: 365288 Page 1 of 1
�`i. ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $15.00
.? CARMEL, INDIANA 46032 15468 FOLLOW DRIVE
NOBLESVILLE IN 46060 CHECK NUMBER: 217957
CHECK DATE: 3/1312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4357004 REIMB 15 . 00 EXTERNAL INSTRUCT FEE
Carmel
arks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
1/2s/13 SewSte, t oa 1 43S-1oo4 E-X - Ir`s�: F� 15.e—° Food N6vjle►. P,4.4
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name(print) 116 .5 ,Q*r4jkA,e =BY:
Address JsOg3O ��; ��,ir;tl ��
Check
payable to: City, St, Zip ,r
Signature: Approved by.
Date: -�Z5113 Date: Z�Z121U
Business Services Division, Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
Order Status littps://NvNvw.sei-vsafe.com/ss/catalog/order_status.aspx?ID=1832935...
View Order History(order history.aspx)
Take Online Course(/ss/courses/coursemanagement/courses aspx)
ORDER PLACED SUCCESSFULLY
Your purchase is now completed.You may click Take Online Course(/ss/courses/coursemanagement/courses aspx)to complete your course.
NRAEF ORDER STATUS
175 West Jackson Boulevard, Customer Number:8618817
Suite 1500 Order Number 1832935
Chicago,Illinois 60604-2702 Status:Shipped
Phone:(800)765-2122 Date Shipped 2/25/2013 12:5959 PM
In Chicagoland:(312)715-1010
SHIP TO BILL TO
Kurtis Baumgartner Kurtis Baumgartner
1235 Central Park Dr.East
1235 Central Park Dr.East Carmel,IN 46032
Carmel,IN 46032
(317)607-0815 Payment Method
Visa####-####- -1676
Shipment Method:Unknown Invoices are sent via email and are delivered to the email address contained in
the customer's user profile.To ensure that you receive these e-mails,you may
• Orders ship out within 48 hours.Click here to view UPS Ground Transit need to add the domain address @restaurant.org to your safe list or address
times(http'//www.ups.cortVmaps/results?zip=601741 book
• We cannot ship orders to P.O.boxes.
• APO/FPO and AE/AP addresses:we ship via USPS Priority Mail,a
non-traceable means.
QUANTITY PRODUCT DESCRIPTION PRICE TOTAL
1 SSEC 5(PRODUCTDETAIL.ASPX?ID=i71o) $15.00 $15.00
SSECT5
PRODUCT(S)SUB-TOTAL: $15.00_
SHIPPING&HANDLING: $0.00
SALES TAX: $0.00
ORDERTOTAL: $15.00
-SECURITY&PRIVACY-J
Every transaction on ServSafe.com is secure.Any personal information you give us will be handled according to our Privacy Policy(#)
RETURNS
1 of 2
2/25/2013 2:02 PM
Kurtis Baumgartner
From: ServSafe - National Restaurant Association [ServiceCenter @restaurant.org]
Sent: Monday, February 25, 2013 2:00 PM
To: Kurtis Baumgartner
Subject: National Restaurant Association Order Confirmation Number 1832935
Dear Kurtis Baumgartner,
Thank you for your order,we greatly appreciate your business.Your confirmation number 1832935. Please reference this number when
making inquiries.
Description
e
SSECT5 ServSafe Food Handler Online Course and Assessment BUNDLE 1 $15.00 $15.00
Sub Total $15.00
Shipping/Handling $0.00
_ Sales Tax $0.00
Grand Total $15.00
Payment method: Credit Card
Bill to:
Kurtis Baumgartner
1235 Central Park Dr. East
Carmel, IN 46032 UNITED STATES
Shipping Method: Unknown
Ship to:
Kurtis Baumgartner
1235 Central Park Dr. East
Carmel, IN 46032 UNITED STATES
You will receive an email notification to inform you when your order ships.
If you need any assistance or have any questions,visit Customer Assistance on ServSafe.com. Please see below for the National
Restaurant Association contact information and business hours.
Service Center
National Restaurant Association
175 West Jackson Boulevard, Suite 1500
Chicago, Illinois 60604-2814
Business hours: 8:00 a.m. to 6:30 p.m. CST
Phone: (800) 765-2122 ext. 6703
In Chicagoland (312)715-1010 ext. 6703
Email:ServiceCenter(d)restaurant.org
1
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Servft
C fficate of 'Am chlevement
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Wong
This s awarded to
Kurtis .Baumigartner
lo.'ngratuiat on.s' Yb,� have ca
ServSafe-- Food Handler
ANSI A(XREDITED PROGRAM
CEIMMATE ISSUER
90655 Employee Food Safety Online Course and Exam
NATIONA L
RESTAURANT 0424-1-9
ASSOCIATION,
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1 of 1 2/25/2013 4:01 PM
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This certificate is awarded to
......... ________. ___Ku r_tl s_B.a u m.g.a r_tn e r_ .___.
1- - - - - - Congratulation_':You have completed - --- - ---- ---
ANSI ACCREDITED PROGRAM a ry a e,u. Food Handier
CERTIFICATE ISSUER
#0655 Employee Food Safety Online Course and Exam
NATIONAL <
RESTAURANT
ASSOCIATION®
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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.
365288 Baumgartner, Kurtis Terms
15468 Follow Drive
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
2/25/13 Reimb ServSafe for Food Handler Certification $ 15.00
Total $ 15.00
I 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.
365288 Baumgartner, Kurtis Allowed 20
15468 Follow Drive
Noblesville, IN 46060
In Sum of$
$ 15.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1091 Reimb 4357004 $ 15.00 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
7-Mar 2013
Signature
$ 15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund