223392 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 363878 Page 1 of 1
0 ONE CIVIC SQUARE SUSAN BEAURAIN
CARMEL, INDIANA 46032 4615 CAROLLTON AVE CHECK AMOUNT: $50.00
INDPLS IN 46205 CHECK NUMBER: 223392
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50 . 00 CELLULAR PHONE FEES
4�
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
8/9/2013 Sprint 1091 4344100 Cellular Phone Fees $ 50.00 August Cell Phone
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $50.00
Employee Name(print) Susan Beaurain L1420]13
Address 4615 Carrollton Ave A
Check
payable to: City, St, Zip Indianapolis, IN 46205 ! --
Signature Approved by:
Date: U Date: ��i q)`t j
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Revised 3-2-07 by Business Services;
Shared/Forms and Templates/Business Service Forms/Employee Exp Reimb Request 2007-3
8/9/13 Sprint-Pay Bill-Credit Card Payment Confirmation
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Payment Date: Aug 09,2013 See my bill
Payment amount: $70.00
Card: Visa See bill history
Last 4 digits: 6283 See—,y order history
Expiration date: 11/2015 See payment history
ZIP code: 46032
Confirmation Number 090413 See my transaction
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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
4615 Carrollton Ave
Indianapolis, IN 46205
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO # Amount
8/9/13 Reimb Cell phone charges Aug'13 S 50.00
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.
363878 Beaurain, Susan Allowed 20
4615 Carrollton Ave
Indianapolis, IN 46205
In Sum of S
$ 50.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
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
22-Aug 2013
$ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund