176613 09/01/2009 CITY OFCAR0EL,INDIANA «swoom 359019 Page 1 of 1
ONE CIVIC SQUARE oAnMsLoTaLLc
CARME�|NoV\wx4soJz nnmmmz«w CHECK AMOUNT: $2,76917
xnw LAU o`LEn CHECK NUMBER: 176613
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CHECK DATE: 9/1/2009
DepARTlmewT *zooVmT PO NUMBER INVOICE NUMBER AMOUNT _DESCRIPTION
902 44608I6 090I09 2,769.17 PELTON
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CARMEL OTS, LLC WIT
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One Pedcor Square
770 3rd Ave. SW
Carmel, Indiana 46032
July 26, 2009
Les Olds
Carmel Redevelopment Commission
For Property Located At:
35 East Main Street
Carmel, IN 46032
Unit 3 of Old Town Slops II
INVOICE
Due: Upon Receipt
Charge Date Item Amount
09/01/09 Monthly Rent 2,769.17
Total Amount Due 2,769.17
If you have any questions please contact Laurie Siler at 317.587.0467
Please make checks payable and mail to:
Carmel OTS, LLC
Attn: Laurie Siler
770 3rd Ave SW
Carmel, Indiana 46032
r Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
OT$ I— L C Purchase Order No.
Col- 614
770 3���/�v� Terms
g,- /�Jj �6� 2 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
-7 -6/0 G d ,Z 7e
Total 27 17
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
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Board Members
PO# or
DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
45/,0,F/6 1769 ,17 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
3/ 20 0,9
Signature
Director of Operations
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund