173754 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 357371 Page 1 of 1
ONE CIVIC SQUARE CARMEL OLD TOWN ANTIQUE MALL CHECK AMOUNT: $49.30
CARMEL, INDIANA 46032 38 W MAIN ST
CARMEL IN 46032 CHECK NUMBER: 173754
CHECK DATE: 6/24/2009
DEPARTMENT AC PO NUMB INVOIC NU MBER A DESCRIPTION
902 4346500 49.30 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 TO
ANTIQUE MALL
38 W MAIN ST
CARMEL, IN 46032
Property Owners /s 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
a
Grant Request
(25% up to $250)
Attachments:
Copy of ad with logo
i/
Paid Invoice
Signature of Owner /s Date
Mailing Address
CARMEL OLD 10
A \N- MAIN ST
38 W 46032
CAR L
3E_56 6 .1908
PH:
CheckImage Page 1 of 1
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dmg world media (USA) inc
P.O. Box 90
Knightstown, IN 46148 INVOICE
Phone 800 876 -5133 Fax Invoice Date Invoice
Bill To: 6/4/2009 88377
Carmel Old Town Antique Mall Pay this anfount
$202.23
38 W Main St. By: 7/4/2009
Carmel, IN 46032
Make checks payable to: dmg world media (USA) inc
a Please check box if address is incorrect or has changed, and Have E -Mail? Please write it here:
indicate change(s) on reverse side.
------------------------------------------e—®__ev—m_—m—
dmg world media (USA) inc PLEASE DETACH AND RETURN TOP PORTION WITH PAYMENT
P.O. Box 90
Invoice Date: 6/4/2009 Invoice 88377
Knightstown, IN 46148 P.O. No. Terms Due Date Order
2.5/10 Net 30 7/4/2009 1 104400
Ad Type Description Pub Issue Column Inches Amount
DNC Display Ad; Color None; Published on 06/08/2009 AWC2082 8 202.23
2 1/2% discount if paid within 10 days
THERE WILL BE A $15 CHARGE FOR ALL RETURNED CHECKS Total $202.23
1.75% INTEREST, 21% ANNUAL WILL BE ASSESSED ON ALL
UNPAID BALANCES AFTER 30 DAYS Payments /Credits $0.00
Billing Inquiries? Call 800 876 -5133
Balance Due $202.23
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
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C I "'WW 0/ /T'_W17 /`I1 A Purchase Order No.
3 8 A�'� Terms
C 1;;K", IX Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
(0 6 O Cc o a�v� y h 4 �9 3 0
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Total -3C>
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. c'
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
5 eel.
Zti
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I 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
.2 p�
Signatioe
Director of OpQrations
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund