224258 09/23/2013 CITY OF CARMEL, INDIANA VENDOR: 366940 Page 1 of 1
ONE CIVIC SQUARE NICHOLE HABERLIN
CARMEL, INDIANA 46032 C/O PARKS CHECK AMOUNT: $75.00
CHECK NUMBER: 224258
CHECK DATE: 9/23/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 75 . 00 CELLULAR PHONE FEES
Carmel 0 Clay FD
- SEP 11 2013
Parks&Recreation
Employee Expense Reimbursement Request BY:
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
UI v I �/u l� 1091 4344100 Cell Phone Charges $ 25.00 kjtkn CLU
N U
All receipts should be attached in the same order as listed above. -T
No sales tax will be reimbursed. TOTAL:
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Employee Name(print) Nldqd�-
Check Address ` 6'� �N lV�� {'�l�/d
payable to: City, St, Zip Sin zn 3�N
Signature: Approved by.
Date: / Date:
Business Services Division, Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
9/9/13 BillPaWr I Bill Detail
Bill History
Bill Detail
Biller Name Account Amount Pay Date Confirmation Status
VERIZON WIRELESS *38009 $122.94 07/01/2013 FZ07K-T14DV Paid
phone
*00001
The funds for your payment to VERIZON WIRELESS were withdrawn from your*38009 account on 07/01/2013.
VERIZON WIRELESS received your payment electronically on 07/01/2013.
Your payment was posted to your VERIZON WIRELESS account on 06/29/2013.
If you 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
07/14/2013 Due:$122.94
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9/9/13 BillPaWr I Bill Detail
Bill History
BW Detail
Biller Name Account Amount Pay Date Confirmation Status
VERIZON WIRELESS *38009 $109.11 08/13/2013 G3GKX-3LNSG Paid
phone
*00001
The funds for your payment to VERIZON WIRELESS were withdrawn from your*38009 account on 08/13/2013.
VERIZON WIRELESS received your payment electronically on 08/13/2013.
Your payment was posted to your VERIZON WIRELESS account on 08/13/2013.
If you 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
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08/14/2013 Due:$109.11
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9/9/13 BillPayer I Bill Detail
Bill History
Bill Detail
Biller Name Account Amount Pay Date Confirmation Status
VERIZON WIRELESS *38009 $109.18 09/09/2013 66797-WKPLY Paid
phone
*00001
The funds for your payment to VERIZON WIRELESS were withdrawn from your*38009 account on 09/09/2013.
VERIZON WIRELESS will receive your payment electronically on 09/09/2013.
Your payment was posted to your VERIZON WIRELESS account on 09/07/2013.
If you 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
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09/14/2013 Due:$109.18
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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.
366940 Haberlin, Nichole Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
9110/13 Reimb Cell phone reimbursement Jun,Jul,Aug'13 $ 75.00
Mileage 1/28/13
Total $ 75.00
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.
366940 Haberlin, Nichole Allowed 20
In Sum of$
$ 75.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
Po#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1091 Reimb 4344100 $ 75.00 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
19-Sep 2013
Signature
$ 75.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund