166611 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 357371 Page 1 of 1
ONE CIVIC SQUARE CARMEL OLD TOWN ANTIQUE MALL
CARMEL, INDIANA 46032 38 W MAIN Sr CHECK AMOUNT: $50.00
CARMEL IN 46032 CHECK NUMBER: 166611
CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUMBER IN NU MBER A MOUN T DESCRIPTION e
902 4346500 111408 50.00 CITY PROMOTION ADVERT
Application Cover Sheet
Carmel Redevelopment Commission Grant'Request
Carmel Arts and Design District
Cooperative Advertising Program
CARMEL OLD TOWN
Property Ownersls ANTICii€,M
38 W. MAIN ST.
CARMEL, IN 46032
Property Location PH: 317 566 -190
Terms of cooperative.advertising program:
Merchant must turn in funding request
Ad must include Arts and Design District Logo
Paid invoice and copy of ad must be submitted with funding request
If funding is -approved, CRC will reimburse merchant for 25% of ad,
up to $250 per ad
Merchant maximum per year is $500
Funding its allocated on first first served basis
Total Cost of Advertisement R 6 0
Grant Request
(25% up to $250)
Attachments:
Copy of ad with logo
V
Paid Invoice
'f
Signature of Owner /s Date
Mailing Address CARMEI n�
ANTIQUE MALL
C ARME L N 460
PH: 317 sg6 -y Q 3�2
TRAVELHOST of Indianapolis
P.O. Box 185 In voice
Ellettsville, IN 47429
Uni States DU
11/20/2008 1945
BILL TO SHIPTO
Carmel Old Town Antique Mall Carmel Old Town Antique Mail
38 W. Main St. 38 W. Main St.
I Carmel, IN 46032 Carmel, IN 46032
M P_ROJEGT�`
888.82& 1090 10/29/2008 JanuarylFebrua y 2009
ITEM DESCRIPTION QTY RATE :AMOUNT
COTAM 1 small ad on antique theme (for one insert) 1 f 200.001 200.00
COTAM INC DBA �78�
I
CARMEL OLD TOWN ANTIQUE MALL
38 WEST MAIN STREET 20.7/740
CARMEL.IN46032
1 Date
Pay to the
fl� Order of 4 V
Dollars
HUNT INGTON
N
r
For o
��t2vWl r
Ia0 7 40000 7810
0 qi ioo P.
78 L
GH'R1JfAN SAFETY ®YELLOW
Subtotal 200.00
Please remit payment to: TRAVELHOST of Indianapolis, P.O. Box 185, Ellettsville, IN 47429 0.00% Tax
0.00
Total 200.00
Amount Paid: 0.00
Balance Due: 200.00
0 days 31 60 days 61 90 days 90 days Total
0.00 0.00 0.00 0.00 200.00
Preetttbed 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.
``__ii Payee rn
�IU W I `V-�� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
//1Cc- tre /h.�S UU
b
Total 5D. 0
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.
ALLOWED 20
im mk up} �Q e IN SUM OF
3� W, M CU
Ct'LA
sz� -mod
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
?6 Z H l L10 S i13L/6,5 5-7.Ob 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
G 20 C)
C Sature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund