313643 7/14/2017 ,a ar C��Mf!
,;; � CITY OF CARMEL, INDIANA VENDOR: 371797 CHECK AMOUNT: $*******100.00*
ONE CIVIC SQUARE KRIYA SHAKTI INC CHECK NUMBER: 313643
?� CARMEL, INDIANA 46032 2444 HOPWOOD DRIVE
CARMEL w asoaz CHECK DATE: 07/14117
'MlION G�`
DESCRIPTION
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT OTHER EXPENSES
101 5023990 FACILITY USE 100.00
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
a a`q_ iqr and jrri5hciO� Purchase Order No.
a r'ypf�O�� ��• Terms
Co-rme` N �3'D- Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
(Ylan ct )00 --
Ld
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
I * . OLLP - 5
Nancy Heck
TY OF CARMEL Charlie Driver_ I-n Corit►�'t�a►t ' dM
�j C� Adam Harrington 1
S FACILITY USE REQUEST FORM
Q�
Name/Organization: Kriya Shakti Inc. ,I' rice
e�
Point of Contact: Mangala Anand, Rahul
Devathu V
Address: 2444 Hopwood Drive
City,State,zip: Carmel, IN-46032
Home Phone: 1317)8109239 Cell Phone: 131718697884
Email Address: manAala ranaawahoo.com Fax Number NA
For Profit Organization: NA Non-Profit Organization: 4 Individual: NA
Day and Date Requested: July 22,2017
Time Requested: 8:00 a.m. to: 11:00 a.m. (This includes set-up and clean-up time.)
Rehearsal Date: NA Time:
a.m./p.m./noon to ______,a•m•/P-m•/midnight.
City Facility Requested: Gazebo Fountain Area_ Japanese Garden YES
Palladium Center Green_Caucus Room(1/3) (2/3)_Council Chambers
Special Requests: Electricity_ Fountain Restroom_ Other Shelter at Japanese garden
or Gazebo at the City hall
Purpose: ADA community Walk Number of People Expected: 100-125
Vendors: Yes_,-, No 4(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: NA
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 Seventh day of July,2017.