168900 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 357371 Page 1 of 1
ONE CIVIC SQUARE CARMEL OLD TOWN ANTIQUE MALL
INDIANA 46032 38 W MAIN ST CHECK AMOUNT: $50.00
CARMEL
4'' CARMEL IN 46032
CHECK NUMBER: 168900
CHECK DATE: 2/17/2009
D EPARTM ENT ACCO UNT PO NUMBER INVOICE NUMBER AMOUNT DESC RIPTION
902 4346500 12009 50.00 CITY PROMOTION ADVERT
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Application Cover Sheet
Carmel Redevelopment Commission Grant Request
Carmel Arts and Design District
Cooperative Advertising Program
CARMEL OLD TOWN
Property Owners /s ANTIQUE MALL
38 W. MAIN ST.
CARMEL, IN 46032
PH: 317 566 -1908
Property Location
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 is allocated on first -come, first served basis
Total Cost of Advertisement
Grant Request
(25% up to $250)
Attachments: j
V Copy of ad with sago
Paid Invoice
Signature of Owner /s Date
Mailing Address CARMEL OLD TOWN
38 W. MAIN ST.
CARMEL, IN 46032
PH: 317- 566 -1908
TRAVELHO T of Indianapolis
P.O. Box 185
Ellettsville, IN 47429 DU( DATE INVOIC
United States 1/20/2009 1990
BILL T_ SHIP. TO
O
Cannel Old Town Antique Mall Cannel Old Town Antique Mall
38 W. Main St.
38 W. Main St. I Carmel, IN 46032
Carmel, IN 46032
TERMS CUS In voice
er date; PRO) CT g
E
Phone Nu mb.,
12/29!2008 March /April 2009
ITEM DESCRIPTN
IO
RATE AMOUNT
1 200.00 200-00
COTAM 1 small ad on antique theme (for one insert)
COTAM INC DBA 6895
j CARMEL OLD TOWN ANTIQUE MALL 20an40
38 WEST MAIN STREET
I CARMEL, IN 46032 �(t
t l l Date
Pay to the
�'Z J
Order of
C'Z)
Dollars
II HUNTINGTON
For 1 to V
Io07400007 0 b [400679 0 6911 0 06B9 5
H anane cane n-
GUAADIAe SAFETY9 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 30 days
31 60 days 61 90 days 9U days Total
L 0.00
0.00 0.00 0.00 200.00
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wwwsouthportantiquemall:`net
Prescribec�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))
l /2d o za o
C(2
Total So.Od
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.
ALLOWED 20
/TryH�s %s��� IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
�o2� 3� 6 so�
Board Members
PO# or D PT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
9�2 /2/J 0 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
Cp 20 b
Sign ture
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund