192855 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 358657 Page 1 of 1
ONE CIVIC SQUARE INDIANAPOLIS STAR CHECK AMOUNT: $659.00
CARMEL, INDIANA 46032 PO BOX 677553
DALLAS TX 75267 -7553 CHECK NUMBER: 192855
CHECK DATE: 12/15/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4346000 956249 659.00 CLASSIFIED ADVERTISIN
DETACH AND RETURN TOP PORTION WITH YOUR REMITTANCE
10 DATE 11 NEWSPAPER 2 13 DESCRIPTION OTHER 5 SIZE 7 TIMES RUN 1 19 GROSS AMOUNT 20 NET AMOUNT
REFERENCE 4 COMMENTS /CHARGES 6 BILLED UNITS 6 RATE
19 -Nov 2201504 CAREER FIREFIGHTERSWANTEDCITY OF CARM 1.7143 1 60.00
Friday 5741100 CAREER FIREFIGHTERSWANTEDCITY OF CARA 1.7143
CLASSIFICATION 902 CLASSIFIED 60.00
21 -Nov 2202260 CAREER FIREFIGHTERSWANTEDCITY OF CARM 0.9286 4
Sunday 5741095 CAREER FIREFIGHTERSWANTEDCITY OF CARA 0.9286
CLASSIFICATION 565 CLASSIFIED 599.00
STATEMENT OF ACCOUNT AGING OF PAST DUE AMOUNTS
21 CURRENT DUE 22 30 DAYS 66 DAYS OVER 90 DAYS 26 UNAPPLIED AMOUNT 3 TOTAL DUE
659.00 0.00 0.00 0.00 0.00 659.00
INDIANAPOLIS STAR
307 N. PENNSYLVANIA ST. TEL: (317) 444 -8484 FAX: (317) 444 -6300
P.O. BOX 145, INDIANAPOLIS, INDIANA 46206 -0145 FED. I.D. 13- 2599556
24 INVOICE NUMBER 25 ADVERTISER INFORMATION
1 BILLING PERIOD 6 BILLED ACCOUNT NUMBER 7 ADVERTISER I CLIENT NUMBER 2 ADVERTISER CLIENT NAME
780428 01- NOV -10 TO 30- NOV -10 750624 956249 CITY OF CARMEL FIRE DEPART
LEGEND
The 25 elements of the Standard Advertising Invoice (SAI)
1. BILLING PERIOD 14. OTHER CHARGES OR CREDIT
"FROM" "TO" DATES FOR THIS STATEMENT. ALL INFORMATION RELATING TOAD INCLUDING PURCHASE ORDER NUMBER.
DETAIL OF ALL DISCOUNTS /CHARGES RELATING TOAD.
2. ADVERTISER CLIENT NAME
NAME OF ADVERTISER (IF AGENCY, CLIENT NAME). 15. SAU SIZE
STANDARD ADVERTISING UNIT AD SIZE.
3. TERMS OF PAYMENT
WHEN PAYMENT IS DUE. 16. BILLED UNITS
MEASUREMENT OF AD (COLUMNS X DEPTH).
4. PAGE NUMBER
PAGE STATEMENT FOR MULTI -PAGE STATEMENTS. 17. TIMES RUN
NUMBER OF INSERTION DAYS FOR THIS AD.
5. BILLING DATE
DATE STATEMENT WAS PREPARED. 18. RATE
APPLICABLE NEWSPAPER ASSIGNED RATE.
6. BILLED ACCOUNT NUMBER
NEWSPAPER ACCOUNT NUMBER 19. GROSS AMOUNT
CORRESPONDING TO ELEMENT 8, CALCULATING OF AD PRICING,
EXTENSION OF TOTAL BILLED AMOUNT AT APPLICABLE RATE.
7, ADVERTISER CLIENT NUMBER BEFORE AGENCY COMMISSION,
BILLED ACCOUNT NUMBER CORRESPONDING TO ELEMENT 2.
20. NET AMOUNT
8. BILLED ACCOUNT NAME AND ADDRESS FINAL COST OF AD DUE FOR ADVERTISER (ELEMENT 2).
COMPANY RECEIVING INVOICE.
21. CURRENT NET AMOUNT DUE
9. REMITTANCE ADDRESS SUM OF ELEMENT 20.
RETURN PAYMENT ADDRESS.
22. 30/60 /OVER 90 UNAPPLIED AMOUNT
10. DATE AGING OF PAST DUE BALANCES FOR ADVERTISER,
INSERTION DATE OF AD OR TRANSACTION DATE.
23. TOTAL AMOUNT DUE
11. NEWSPAPER REFERENCE SUM OF ELEMENTS 21 AND 22.
NEWSPAPER'S INTERNAL REFERENCE NUMBER,
24. INVOICE NUMBER
12. DESCRIPTION, OTHER COMMENTS NEWSPAPERS INVOICE/ DOCUMENT NUMBER.
13. PRODUCT SERVICE CODE 25. ADVERTISER INFORMATION
(1) BILLING PERIOD, (6) BILLED ACCOUNT.
(7) ADVERTISER CLIENT NUMBER, (2) ADVERTISER! CLIENT NAME.
The elements shown above appear on the face of the invoice and are identified by number.
VO NO. WARRANT NO.
Indianapolis Star ALLOWED 20
IN SUM OF
P.O. Box 677553
Dallas, TX 75267
$659.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 956249 43- 460.00 $659.00 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
DEC g 3 2010
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
956249 $659.00
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