216754 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 358657 Page 1 of 1
�. ONE CIVIC SQUARE INDIANAPOLIS STAR CHECK AMOUNT: $800.00
CARMEL, INDIANA 46032 PO BOX 677553
o� DALLAS TX 75267-7553 CHECK NUMBER: 216754
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1801 4346000 43859 800 . 00 CLASSIFIED ADVERTISIN
DETACH AND RETURN TOP PORTION WITH YOUR REMITTANCE
10 DATE V NEWSPAPER 2 13 DESCRIPTION/OTHER SIZE 7 TIMES RUN I 19GROSSAMOUNT 20 NET AMOUNT
REFERENCE 4 COMMENTS/CHARGES 6 BILLED UNITS 8 RATE
06-Dec 2436170 GALLERY WALK 6 x 5.00 1 800.00
Thursday 5976971.1 GALLERY WALK 30.00 26.67
WEEKEND 800.00
STATEMENT OF ACCOUNT AGING OF PAST DUE AMOUNTS
21 CURRENT DUE 122 30 DAYS 60 DAYS OVER 90 DAYS 26 UNAPPLIED AMOUNT 3 TOTAL DUE
800.00 800.00 0.00 0.00 0.00 1,600.00
INDIANAPOLIS STAR
307 N.PENNSYLVANIA ST. TEL:(317)444-8484 FAX:(317)444-8300
P.O.BOX 145,INDIANAPOLIS,INDIANA 46206-0145 FED. I.D. 13-2599556
24 INVOICE NUMBER 25 ADVERTISER INFORMATION
1 BILLING PERIOD 6 BILLED ACCOUNT NUMBER 7 ADVERTISER/CLIENT NUMBER 2 ADVERTISER/CLIENT NAME
854605 01-DEC-12 TO 31-DEC-12 13065 43859 CARMEL ARTS&DESIGN DIST
LEGEND
The 25 elements of the Standard Advertising Invoice (SAI)
1. BILLING PERIOD 14. OTHER CHARGES OR CREDIT
"FROM""TO"DATES FOR THIS STATEMENT. ALL INFORMATION RELATING TO AD INCLUDING PURCHASE ORDER NUMBER.
DETAIL OF ALL DISCOUNTS/CHARGES RELATING TO AD.
2. ADVERTISER/CLIENT NAME
NAME OF ADVERTISER(IF AGENCY,CLIENT NAME). 15. SAU SIZE
STANDARD ADVERTISING UNIT AD SIZE.
3. TERMS OF PAYMENT
WHEN PAYMENT IS DUE. 16. BILLED UNITS
MEASUREMENT OF AD(COLUMNS X DEPTH).
4. PAGE NUMBER
PAGE STATEMENT FOR MULTI-PAGE STATEMENTS. 17. TIMES RUN
NUMBER OF INSERTION DAYS FOR THIS AD.
5. BILLING DATE
DATE STATEMENT WAS PREPARED. 18. RATE
APPLICABLE NEWSPAPER ASSIGNED RATE.
6. BILLED ACCOUNT NUMBER
NEWSPAPER ACCOUNT NUMBER 19. GROSS AMOUNT
CORRESPONDING TO ELEMENT 8. CALCULATING OF AD PRICING.
EXTENSION OF TOTAL BILLED AMOUNT AT APPLICABLE RATE.
7. ADVERTISER/CLIENT NUMBER BEFORE AGENCY COMMISSION.
BILLED ACCOUNT NUMBER CORRESPONDING TO ELEMENT 2.
20. NET AMOUNT
8. BILLED ACCOUNT NAME AND ADDRESS FINAL COST OF AD DUE FOR ADVERTISER(ELEMENT 2).
COMPANY RECEIVING INVOICE.
21. CURRENT NET AMOUNT DUE
9. REMITTANCE ADDRESS SUM OF ELEMENT 20.
RETURN PAYMENT ADDRESS.
22. 30/60/OVER 90 UNAPPLIED AMOUNT
10. DATE AGING OF PAST DUE BALANCES FOR ADVERTISER.
INSERTION DATE OF AD OR TRANSACTION DATE.
23. TOTAL AMOUNT DUE
11. NEWSPAPER REFERENCE SUM OF ELEMENTS 21 AND 22,
NEWSPAPER'S INTERNAL REFERENCE NUMBER.
24. INVOICE NUMBER
12. DESCRIPTION, OTHER COMMENTS NEWSPAPERS INVOICE/DOCUMENT NUMBER.
13. PRODUCT/SERVICE CODE 25. ADVERTISER INFORMATION
(1)BILLING PERIOD,(6)BILLED ACCOUNT.
(7)ADVERTISER/CLIENT NUMBER,(2)ADVERTISER/CLIENT NAME.
The elements shown above appear on the face of the invoice and are identified by number.
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
T t 1 w\ 1 ,fir Purchase Order No.
x/617 SS3 Terms
Wks , T l� � 510 —155-3 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
IZ X112. 8 0 r� veA0owenk 8
Total U U 0
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
f ALLOWED 20
Z n�i an h nl►s STAY' IN SUM OF $
P, O. QoX 6��ss3
TX
$
ON ACCOUNT OF APPROPRIATION FOR
Igol1� 3�4000
Board Members
PO#or
D PT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s),
b g5 S �3�6Qo� g o,°� 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�— 2013
Signature
Executive Director
Title
Cost distribution ledger classification if Carmel Redevelopment Commission
claim paid motor vehicle highway fund