170946 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 362775 Page 1 of 1
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ONE CIVIC SQUARE YUKIKO KIKUCHI CHECK AMOUNT: $45.84
�a CARMEL, INDIANA 46032 324 W MAIN ST
CARMEL IN 46032 CHECK NUMBER: 170946
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUNT PO NUMBER INV OICE NUMB AMOU DESCRIPTION
902 4346500 1073 45.84 CITY PROMOTION ADVERT
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Application Cover Sheet
Carmel Redevelopment Commission Grant Request
Carmel Arts and Design District
Cooperative Advertising Program
Property Owners]s Yu k;ko K i kivdi i
Property Location 2�' M0 1 St. Sar 1 L N 6 032
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 �f- 9 C�
(25% up to $250)
Attachments:
Copy of ad with logo
Paid invoice
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Signatur of Owneds Data
Failing Address J 2q W. M a; 1 1+ S f �'crymel Lhl `�d 03 2
III UT ji NEWSPAPER J2 13 DESCIUPTIOMWHER 5 SIZE 7 TIMES RUN JROSS AMOUNT 20 NFT AMOUNT
REFERENCE 4 COMMENTS I CHARGES 6 BILLED UNITS 6 RATE
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14 Dec 1059 Payme t R6telved Thank Y1u1 118.38 CR
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STATEMENT OF ACCOUNT RAGING OF PAST DUE AMOUNTS
21 CURRENT DUE 122 30 DAYS 60 DAYS OVER 90 DAYS 26 U14APPLIED AMOUNT 3 TOTAL DUE
0.00 C65.007 0.00 0.00 0.00 65.00
INDIANA NEWSPAPERS. INC.
307 N. PENNSYLVANIA ST. TEL: (317) 444 -8464 FAX: (317) 4444300
P.O. BOX 145. INDIANAPOLIS, INDIANA 40268 -0145 FED. I.D. 35-2061385
24 INVOICE NUMBER 125 ADVERTISER INFORMATION
i BILLING PERIOD 9 EIILLEL)Accouffr NUMBER 17 ADVERTISER CLIENT NUMBER 12 ADVERTISER I CLIENT NAME
666249 01- DEC -08 TO 31- DEC -08 16052 45557 CREME DE LA CREME