220431 05/22/2013 CITY OF CARMEL, INDIANA VENDOR: 366940 Page 1 of 1
i ONE CIVIC SQUARE NICHOLE HABERLIN CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032 C/O PARKS
CHECK NUMBER: 220431
CHECK DATE: 5/22/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 50 . 00 CELLULAR PHONE FEES
Carmel o Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
b 4 t/�u Ce�� 8113
2 t�"Q- � 1 Y� I�•�ON 1091 4344100 Cell Phone Charges $ 25.00 S
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All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
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Employee Name(print)-MI&p14 >tTLLUGI'lty�
Check Address g159 Wor-A107g46i Ig(vd.
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payable to: City, St, Zip Q
Signature: Approved by:
Date: qpt,/ Date: 41 Z3 I
RE CAVED
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request APR 2 5 2013
BY:
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An,
At
4/23/13 BillPayer I Bill Detail
Bill History
Bill Detail
Biller Name Account Amount Pay Date Confirmation Status
VERIZON WIRELESS *38009 $106.19 03/28/2013 FNHXR-NPLPO Paid
phone
*00001
The funds for your payment to VERIZON WIRELESS were withdrawn fromyour*38009 account on 03/28/2013.
VERIZON WIRELESS received your payment electronically on 03/28/2013.
Ifyou have a question about your bill or about crediting the payment to your biller account,please contact VERIZON
WIRELESS directly.
If you have a question about this payment,you can send us a payment inquiry.
View Bill
Due Date Amount Account Balance
04/14/2013 Due:$106.19
I
https://bi I I payl.pscufs.com/cvA 11/wps?rq=pv&s p=17028&oss=44eeO780d 1 OOf7e4bOb7f6868Od6554b&osn=&i d=20130327162525736729&.done=wps%3F r q%3D
4/23/13 BillPaWr I Bill Detail
Bill History
Bill Detail
Biller Name Account Amount Pay Date Confirmation Status
VERIZON WIRELESS *38009 5106.12 04/24/2013 FR7H2-QQLKT Pending
phone
*00001
This bill payment is pending.The payment will be processed in time for the biller to receive it by the pay date.
View Bill
Due Date Amount Account Balance
05/14/2013 Due:$106.12
�ttps://billpayl.pscufs.com/cMll/wps?webc=ph&rq=pv&sp=17028&oss=44eeO780dlODf7e4bOb7f6868Od6554b&osn=&id=20130423143921052874&.done=wps%/ . 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.
366940 Haberlin, Nichole Terms
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO # Amount
4/23/13 Reimb Cell phone charges Mar,Apr'13 $ 50.00
Mileage 1/28/13
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.
366940 Haberlin, Nichole Allowed 20
In Sum of$
$ 50.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
INVOICE NO. ACCT#/TITL AMOUNT
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
16-May 2013
Signature
$ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund