HomeMy WebLinkAbout313527 7/10/2017 4��,��'`'• CITY OF CARMEL, INDIANA VENDOR: 371756
ONE CIVIC SQUARE KIMBERLY MCCAULEY CHECK AMOUNT: $**'**"*100.00*
4r� CARMEL, INDIANA 46032 629 E COLUMBINE LANE CHECK NUMBER: 313527
WESTFIELD IN 46074 CHECK DATE: 07/10/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GAZEBO 100.00 OTHER EXPENSES
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Nancy Heck QV_NSH
' Lt.Joe Bickel
Adam Harrington
CITY OF CARMEL --
FACILITY USE REQUEST FORM
Name/Organizadon: u�nbe�lu IM ,(A�P�I
Point of Contact: INI I Y Vc r L� N
Address: Ulm ll • (i�)lI wigi lot U1
City,State,Zip: jAkgt�l ell JW 1A(9(q`–t'
Home Phone: (_1) 0 N)A M I Cell Phone:Z1)uw- Am I
Email Address: i y-Amm1 MMCA�A Fax Number ()-----
For Profit Organization: \ Non-Profit Organization: Individual:
Day and Date Requested: LV W
Time Requested: G�/p.m. t0: a.m.,J&(This Includes set-up and clean-up time.)
Rehearsal Date: " Time: a.m./p.m. to a.m./p.m.
City Facility Requested: Gazebo ?L Fountain Area Japanese Garden
Palladium Center Green Caucus Room (1/3)—(2/3)_Council Chambers
Special Requests: Electricity X Fountain Restroom Other
Purpose: YAW , jfjwa �!21 Number of People Expected:
Vendors: Yes_ No ?(- (See Item 5,City of Carmel Facility Use Policy attached)
City Street Closing: (See Item 9,City of Carmel Facility Use Policy attached)
Large or Race Events:
Neighborhood Street Closing(Street(s),Address(es)Blocked)
The Carmel Board of Public Works and Safety reserves the right,in its sole discretion,to deny
any facility use request and/or revoke any previously granted request to use a City facility for
any lawful reason.
Received this 201
MAyorgS Office
Revised: 01/01/2016
Approvals/Date
Nancy Heck oy-W-H
' Lt.Joe Bickel �3 -
Adam Harrington
CITY OF CARMEL
FACILITY USE REQUEST FORM
Name/Organization:
WA ey N IMC Ca i ne.
Point of Contact: Yv k Y l�
Address:
City,State,Zip: ��✓�� �'�� N ��`T
Home Phone: ( 11 ( U A)•y1 ffl I Cell Phone:Ell) UN)" AW
Email Address: ddy1 mml (M!1nh� Fax Number (For Profit Organization: Non-Profit Organization: Individual:
Day and Date Requested: )t� �1 -4-Zt /gU 11
30
Time Requested: /p.m. to: . ,30 a.m.l�.(This includes set-up and clean-up time.)
Rehearsal Date: _ Time: a.m./p.m. to a.m./p.m.
City Facility Requested: Gazebo Fountain Area Japanese Garden
Palladium Center Green Caucus Room(1/3)_(2/3)_Council Chambers
Special Requests: Electricity X Fountain Restroom Other
Purpose: Mw s V ma Q1) Number of People Expected:
Vendors: Yes_ No �' (See Item 5,City of Carmel Facility Use Policy attached)
City Street Closing: (See Item 9,City of Carmel Facility Use Policy attached)
Large or Race Events:
Neighborhood Street Closing(Street(s),Address(es)Blocked)
The Carmel Board of Public Works and Safety reserves the right,in its sole discretion,to deny
any facility use request and/or revoke any previously granted request to use a City facility for
any lawful reason.
Received this /, . � 6 '- • 201
Mayor's Office
Revised: 01/01/2016
VOUCHER NO. WARRANT NO.
ALLOWED 20
_�l CY�b�H �'ICCGcn.�ey IN SUM OF $
(oa ti C,61u.rn.6ne.,Lcre
$ boa —
ON ACCOUNT OF APPROPRIATION FOR
-kcot C,e,
Board Members
Po#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
50a39tio /00bill(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
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund