226113 11/18/2013 CITY OF CARMEL, INDIANA VENDOR: 367745 Page 1 of 1
ONE CIVIC SQUARE MICHAEL KILPATRICK
CARMEL, INDIANA 46032 C/0 ESE CHECK AMOUNT: $50.00
CHECK NUMBER: 226113
CHECK DATE: 11/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 REIMB 50 . 00 CELLULAR PHONE FEES
Carmel ® Clay
Parks&Recreati®n NOV 91 2993
Employee Expense Reimbursement Request $ -- ---
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
c a5 . oC� C ll a�E
1All receipts should be attached in the same order as listed above. -T
No sales tax will be reimbursed. TOTAL: <� d
Employee Name(print) M) C11L- / k1 )Pce ll-i'ck
Address 3
Check
payable to: City, St, Zip 5A t6 C"v� -T,') LJ&ac-q
Signature: L� ��� � �1 �7` � Approved by:
Date: l G' l� �' �l 3 Date: lot 301 R
Business Services Division,Revised 7-7-08
FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request
P.O.BOX 4002 Manage Your Account&View Your Usage Details Account Number Date Due
ACWORTH,GA 30101
Address Changed?—go to vzw.com/changeaddress Invoice Number 2971552312
Quick Bill Summary Aug 21 -Sep 20
KEYLINE
/4606987253/
RENEE KILPATRICK Previous Balance (see back for details) $134.92
2335 W 236TH ST Payment—Thank You —$134.92
SHERIDAN,IN 46069-8725 Balance Forward $.00
Monthly Charges $114.36
Usage and Purchase Charges $14.25
Verizon Wireless' Surcharges
and Other Charges&Credits $8.64
Taxes,Governmental Surcharges&Fees $10.30
Total Current Charges $147.55
Don t Forget To Renew Total Charges Due by October 15, 2013 $147.55
Your Discount
To continue to receive your monthly
discount,please validate your
employment or affiliation status before
your next bill at vzw.com/renewdiscount.
See"Need-to-Know Information"section
of this bill for details.
Pay from Wireless I Pay on the Web Questions:
VN
Bill Date September 20,2013
Account Number 481004485-00001
Invoice Number 2971552312
RENEE KILPATRICK Total Amount Due by October 15, 2013
2335 W 236TH ST
SHERIDAN,IN 46069-8725 Make check payable to Verizon Wireless.
Please return this remit slip with payment. S 147.55
s ❑❑❑ m F-1 1:1
P.O.BOX 25505
LEHIGH VALLEY, PA 18002-5505
F] /1800255054/
Check here and fill out the back of this slip if your billing address
has changed or you are adding or changing your email address.
2971552312010481004485000010000147550000147553
NOTICE:Bank account and routing numbers will be retained to enable future payments by phone or online.To opt out,call 1-866-544-0401.
P.O.BOX 4002 Manage Your Account&View Your Usage Details Account Number Date Due
ACWORTH,GA 30101 , , , i
Address Changed?—go to vzw.com/changeaddress Invoice Number 2985399790
Quick Bill Summary Sep 21 -Oct 20
KEYLINE
/4606987253/
RENEE KILPATRICK Previous Balance (see back for details) $147.55
2335 W 236TH ST Payment—Thank You —$147.55
SHERIDAN,IN 46069-8725 Balance Forward $.00
Monthly Charges $114.36
Usage and Purchase Charges $6.20
Verizon Wireless' Surcharges
and Other Charges&Credits $8.63
Taxes,Governmental Surcharges&Fees $9.74
Total Current Charges $138.93
Introducing Verizon Edge Total Charges Due by November 15, 2013 $138.93
Discover the newest way to upgrade.Get
the phone you want,when you want it.
No down payment.No finance charges or
upgrade fees.Visit go.vzw.com/edgeinfo
for details.
Pay from Wireless I Pay on the Web Questions:
VN
Bill Date October 20, 2013
Account Number 481004485-00001
Invoice Number 2985399790
As part of Verizon's Go Green Initiatives,your
RENEE KILPATRICK remit envelope will be omitted next month. $138.93
2335 W 236TH ST Please see Need—to—Know message for further info.
SHERIDAN,IN 46069-8725
s ❑00 0 F]1:1
P.O.BOX 25505
LEHIGH VALLEY, PA 18002-5505
F-1 /1800255054/
Check here and fill out the back of this slip if your billing address
has changed or you are adding or changing your email address.
2985399790010481004485000010000138930000138933
NOTICE:Bank account and routing numbers will be retained to enable future payments by phone or online.To opt out,call 1-866-544-0401.
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.
Kilpatrick, Michael Terms
2335 West 236 St
Sheridan, IN 46069
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
10/28/13 Reimb Cell phone charges Aug, Sep'13 $ 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.
Kilpatrick, Michael Allowed 20
2335 West 236 St
Sheridan, IN 46069
In Sum of$
$ 50.00
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or Board Members
Dept#
INVOICE NO. CCT#/TITL AMOUNT
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
14-Nov 2013
�e)&"4134 Jot
Signature
$ 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund