315781 9/6/2017 �,CA96
CITY OF CARMEL, INDIANA VENDOR: 371907 CHECK AMOUNT: $**.....100.00*
ONE CIVIC SQUARE NAMASTE YOGA CHECK NUMBER: 315781
CARMEL
CARMEL, INDIANA 46032 DUBLIN DRIVE
4? i CARMEL IN 46033 CHECK DATE: 09/06/17
9M(TpH�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GAZEBO 100.00 OTHER EXPENSES
VOUCHER NO. WARRANT NO.
ALLOWED 20
Nama��e y�,JcL. IN SUM OF $
c,rcc 1 � a,1
br..
$ 1ob
ON ACCOUNT OF APPROPRIATION FOR
Board Members
G(42� U QC�il�ul( W�nn -
PO#or# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or
DEPT.
lot 150,A39 gC It_ 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
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Approvals/ uate
Nancy Heck 7'Z `(I
Charlie Driver '1 ;20 t1
CITY OF CARMEL Adam Harrington -7-ay-1l
FACILITY USE REQUEST F - -
. jumt ool C
anization. 1 V
dme/Org
Point of Contact: ,1%1 C)
Address: `� 00mi n
City,State,Zip:
Home Phone: ( O 0 Cell Phone: (510 W D l g q
Email Address: 1 Z I 01daU Gb F x Number
For Profit Organization: Non-Profit Organization: Individual:
Day and Date Requested: 00w ikM
Time Requested: a•m to: a.m p.m.(This includes set-up and clean-up time.)
Rehearsal Date: Time: a.mJp.m. to a.mJp.m.
City Facility Requested: Gazebo lx_ Fountain Area Japanese Garden
Palladium Center Green Caucus Room(1/3)_(2/3)_Council Chambers
Special Requests: Elect 'city—L Fou tain Restroom Y\ Other
Purpose: 1 V umber of People Expected:
�ZQ�
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 day of 9201
Mayor's Office
Revised: 01/22/16