221414 07/02/2013 °'wF CITY OF CARMEL, INDIANA VENDOR: 365288 Page 1 of 1
` ONE CIVIC SQUARE KURTIS BAUMGARTNER
CARMEL, INDIANA 46032 15468 FOLLOW DRIVE CHECK AMOUNT: $25.00
NOBLESVILLE IN 46060
CHECK NUMBER: 221414
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 25 . 00 CELLULAR PHONE FEES
Carmel ® Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
6/14/2013 AT&T I L+ CO ,, F{�,p $ 25.00 Monthly Reimbursement
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL:
Employee Name(print) Kurtis Baumgartner JUN 18 20+')
Check Address 16930 Kingsbridge Blvd
payable to: City, St, Zip W t! 074
Signature: Approved by..
Date: V06-112013 Date:
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
KURO3BAUMGARTNER Page 2of4
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317 60T-0815 Other Ch ar dCredits ' C on ti nue d
uunnooAuMGAnTwsn / Included In Plan MB 6.144
Individual M8Used 441
Mobile Share with Unlimited Talk&Text Includes Mobile Others in Group M8 Used 1'201
Share with Unlimited Talk & Text z Gigabyte(so)~ 1024mB, I Megabyte(MB) zoz*xa
international Long Distance' Standard ' Includes Surcharges and Other Fees
international long distance from the U.lto over 22U T. Administrative Fee 0.61
countries atstandard, pay'per'useintemationai rates. See 8. Federal Universal Service Charge 1.58
rates atvvwwattzom/g(obaL 9. Indiana Universal Service 0.13
10. Regulatory Cost Recovery Charge 0.29
Mobile Protection Pack' Enhanced Support and Mobile Locate 11 State Gross Receipts 3urcha,ge O.52
� ' Includes Mobile Insurance Premium (listed below), Enhanced 12. Telecom Relay Service Fund ^ 083
Support and Mobile Locate fora total of $9.99 Total Surcharges and Other Fees 3.26
Mobile Insurance Premium ' Includes Coverage for loss, Government Fees and Taxes
theft, accidental damage, liquid damage, and out-of-warranty 13. 9'1'1 Service Fee 0.90
malfunction. 14. IN State Sales Tax ' Telecom 2.67
Total Government Fees and Taxes 3.57
Mobile Share for iPhone Includes unUmitedAnytime
Minutes, Nationwide Long Distance & Roaming, Unlimited Total Other Charges & Credits 6'83
domestic text, picture, video and instant messages and
unlimited calling to/from any other domestic mobi\e phone' Total for 317 607'0015 138'32
Call Forward feature, Caller ID, Cat[ Wait, Conference [aii
feature. Mobile Share voice and data plan required.
/
Monthly 5 h ] 3 `�^
l. International Long Distance Standard 0.00
2. Mobile Protection Pack ' Enhanced Support lOO Mobile Share with Unlimited Talk& Text Includes Mobile
and Mobile Locate Share with Unlimited Talk & Tex
3. Mobile Insurance Premium 6.99
4. Mobile Share 6G8 with Unlimited Talk & Text 90.00 International Long mistance' Standard Includes
5. Mobile Share for iPhone 35.00 international long distance from the U.S. to over %20
b. National Account Discount 13.50[R countries at standard, pay'per-use international rates. See
Total Monthly Charges 121'49 musatwwwatt.com/gbobai
Mobile Protection Pack' Enhanced Support and Mobile Locate
Other Charges and Credits ' Includes Mobile Insurance Premium (listed below), Enhanced
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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
16930 Kingsbridge Blvd
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO # Amount
6/14/13 Reimb Cell phone charges Apr'13 $ 25.00
i
Total $ 25.00
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.
365288 Baumgartner, Kurtis Allowed 20
16930 Kingsbridge Blvd
Westfield, IN 46074
In Sum of$
$ 25.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1091 Reimb 4344100 $ 25.00 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-Jun 2013
Signature
$ 25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund