171087 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 362265 Page 1 of 1
ONE CIVIC SQUARE SIMPLY SWEET SHOPPE
CARMEL, INDIANA 46032 30 N RANGELINE ROAD CHECK AMOUNT: $150.00
CARMEL IN 46032 CHECK NUMBER: 171087
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4346500 30909 150.00 CITY PROMOTION ADVERT
Application Cover Sheet
Carmel Redevelopment Commission Grant Request
Carmel Arts and Design District
Cooperative Advertising Program
Property Ownersls C_ aj Sk6&C)S2-,
Property Location o C
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 C)
Grant Request
(25% up to $250)
Attachments:
Copy of ad with logo
Pain Invoice
A ig ure of O rls Date
Mailing Address 60 t`�
1 f
par-4
RUM W.
Transaction Period: 02/01/2009 0212812009
Simply Sweet Shoppe Second Story Playhouse Account Number: 1659
Bernie Szuhaj Billing Date: 02128/2009
30 N. Range Line Rd Due Date: NET 30
Carmel, IN 46032 Amount Due: $2,361.81
Please indicate reference number(s) to ensure proper credit: Amount Paid:
Please
reh lap po rti on with paymehi
STATEMENT 1NV010E Page: -t—
Current In Carmel 1 South Rangeline Road, Suite 220 Carmel, IN 46032 (317) 489 -4444
X
02/03/2009 18076- 001' 'Display Ad 275.000 4.87 $200 OOs
CURB 118 H, 4C
02/03/2009 18076 -002 Display Ad 175.000 6.00 $44.00
CIW 118 H, 4C
02/10/2009 18133 -001 Display Ad 275.000 4.87 $200.00
CURR 118 H, 4C
02/10/2009 18133 -002 DisplayAd 175.000 6 -00 $44.00
CIW 1/8 H, 4C
02/12/2009 18268 Check $0,00 $1;000:00
Ck# 1266
02117/2009 18222 -001 Display Ad 275.000 4.87 $200:00
CURR 118 H, 4C
02117/2009` 18222 -002 Display Ad 175.000 6.00 $44.00
CIW 118 H, 4C
02/23/2009 18372 Check $0.00 $1;000:00
Ck #1303
02/2412009 18222 -003 Display Ad 175.000 6.00 $44.00
CIW 118 H, 4C
02/24/2009 18222 -004 Display Ad 275.000 4.87
CURR 118 H, 4C
02/28/2009 Interest $20 -48
Interest
Thank you for advertising with us!
PLEASE NOTE OUR NEW ADDRESS:
1 South Range Line Road Suite 220 Carmel, In 46032
P; �4 a n✓r4�",n�u. .fi�i�, 'r 1re�� 4 v; �2r4 ;YV�
-i C� i e„ av &ti. -'s. av?L r .x'eL .:.eic. f a`3 ..a.�. .$.0 �L��
Simply Sweet Shoppe Second Story 0 $996.48 Previous Balance: $3,365.33
Account No: 1659 Past 30 $1,011.31 Total Credits: $2,000.00
YTD Inches: 87 60 $354.02 Total Charges: $996.48
No of Tears: 0 Info 90 $0.00
120 $0.00
150+1 $0.00
Amount Due: $2,361.81
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
Purchase Order No.
3U N ���7� /�o���/ Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
yG 6- ;aq /So.G7 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
20
L Signatur e
/✓rr/ o C vier DVS
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund