227272 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 365288 Page 1 of 1
ONE CIVIC SQUARE KURTIS BAUMGARTNER CHECK AMOUNT: $25.00
CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD
WESTFIELD IN 46074 CHECK NUMBER: 227272
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4344100 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
12/19/2013 AT&T $ 25.00 cell phone reimbursement
All 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 �--�;
' � �F�
Address 16930 Kingsbridge Blvd LDEC ����
Check
payable to: City, St, Zip stfield, IN 46074
Signature: Approved by:C
.
Date: 12/9/2013 Date: fZ.'i d[j 3
Business Services Division, Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
V
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
12/19/13 Reimb Cell phone reimbursement Nov'13 $ 25.00
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
12-Dec 2013
Signature
$ 25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund