226601 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 365288 Page 1 of 1
ONE CIVIC SQUARE KURTIS BAUMGARTNER
j CHECK AMOUNT: $31.65
CARMEL, INDIANA 46032 16930KINGSBRIDGEBWD
WESTFIELD IN 46074 CHECK NUMBER: 226601
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4343000 REIMB 6 . 65 TRAVEL FEES & EXPENSE
1091 4344100 REIMB 25 . 00 CELLULAR PHONE FEES
Carmel
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
10/23/2013 Indiana Memorial Union IDa LLN 3000 +44,4<j pt $ 6.65 Parking for Job Fair
f N l receipts should be attached in the same order as listed above.
sales tax will be reimbursed. TOTAL:
Employee Name (print) Kurtis Baumgartner
Address 16930 Kingsbrid e Blvd /V r
Check
payable to: City, St, Zip Westfi
_p1d,IN_ 6074
Signature: ,
Approved by \� �!
i
Date: /101412 013 Date:
Business Services Division, Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
Y
6394.8.336.77750 1 AV 0.360 6n AutoPay Enrollment
If I enroll in AutoPay,I authorize AT&T to pay my bill
111111"I"�II�I'lll' 'll'llll��ll�����ll�l����l���l��ll�lll�'ll' monthly by electronically deducting money from my bank
account. I can cancel authorization by notifying AT&T at
KURTIS BAUMGARTNER www.att.com or by calling the customer care number
16930 KINGSBRIDGE BLVD listed on my bill.
WESTFIELD IN 46074-7800 Bank Account Holder Signature:
Date:
DUE BY: Nov 19, 2013
KURTIS BAUMGARTNER
Account Number 243007377604 16930 KINGSBRIDGE BLVD
&t WESTFIELD,IN 46074-7800
Please include account number on your check.
Make checks payable to:
E] CHECK FOR AUTO PAY AT&T MOBILITY
(SEE REVERSE) PO BOX 6416
CAROL STREAM IL 60197-6416
974002430073776040000000001802000000018020008
Carmel 0 Clay
Far s&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
11/19/2013 AT&T Wireless loft $ 25.00 Cell Phone Reimbursement
1All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $25.00
Employee Name(print) Kurtis Baumgartner
Vi5 6V
Address 16930 Kin sbridge Blvd -
Check 01
payable to: City, St, Zip estfield, IN 46074
Signature.. Approved bys�=
Date: 11/7/2013 Date:' r 1 t 1 i'1
Business Services Division, Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
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
10/23/13 Reimb Parking for job fair $ 6.65
11/19/13 Reimb Cell phone charges Oct'13 $ 25.00
Total $ 31.65
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$
$ 31.65
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1091 Reimb 4343000 $ 6.65 1 hereby certify that the attached invoice(s), or
1091 Reimb 4344100 $ 25.00 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
27-Nov 2013
Signature
$ 31.65 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund