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<>; CITY OF CARMEL, INDIANA VENDOR: 371215
ONE CIVIC SQUARE MIKE AINLEY CHECK AMOUNT: $'"`'"*100.00'
f? CARMEL, INDIANA 46032 1474 CLEARWATER CT CHECK NUMBER: 313965
CARMEL IN 46032 CHECK DATE: 07/20/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GAZEBO 100.00 OTHER EXPENSES
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Approvals/Date
Nancy Heck
CITY OF CARMEL Charlie Driver
Adam Harrington to-U-0
FACILITY USE REQUEST FOR
Name/Organization: HAMAL_rjtxj CQCi kA-U0G-Ck W4-L<-
Point
4- KPoint of Contact: ('Y\\
Address: J 4?y C,t_E- reg-3
City,State, Zip: CAP,M r L_ 1 (c O 3 Z
Home Phone: l3S) Ry`t-2"1q 4 Cell Phone: (31)) RqQ- 9_1 2-
Email
Email Address: M I.t L1~y 2 P-,QrNN%,-C io Fax Number
For Profit Organization: Non-Profit Organization: �_Individual:
Day and Date Requested: 00— t F ZOW
Time Requested: . (9' ./p.m. to: S�o a.m p.m. (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 Areal-,/ Japanese Garden
Palladium Center Green Caucus Room (1/3)_(2/3)_Council Chambers
Special Requests: Electricity ✓ Fountain Restroom ✓ Other
wV*yK F0Q 4,j&i(x� t-T iAAM%t (>)
Purpose: C-o ugTl A 'li{g, WaLi> Number of People Expected: 750-Son
Vendors: Yes_ No A, (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: tip
Neighborhood Street Closing(Street(s),Addresses)Blocked) 04 d y
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 day of ,201
Mayor's Office
Revised: 01/22/16