318158 11/7/2017 CITY OF CARMEL, INDIANA VENDOR: 372050 ......
�u+® '�•` CHECK AMOUNT: $" 100.00"
ONE CIVIC SQUARE JOHN PRICKER 17731 SUNDIAL COURT CHECK NUMBER: 318158
,} 3° CARMEL, INDIANA 46032 WESTFIELD IN 46062 CHECK DATE: 11/07/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
OTHER EXPENSES
101 5023990 GAZEBO 100.00
WARRANT NO., 20,
VOUCHER NO.----
ALLOWED
IN SUM OF $
J a�
rl 31
ON ACCOUNT OF APPROPRIATION FOR
Board Members
ACCT#(TITLE AMOUNT 1 hereby certify that the attached in hat the' °r
Po#o� wvolcE N�� bill(s) is (are) true and correct an
DEPT.# �� 39
-- materials or services itemized thereon for
which charge is made were ordered and
received except
� 20
Signa re
D�r
Title
Cost distribution ledger classiticatio
claim paid aid motor vehicle highway tund
Approvals/Date
-"__ Nancy Heck
Charlie Driver
Adam Harrington
CITY OF CARMEL
FACILITY USE/EVENT REQUEST FORM
Name/Organization: ��/J GR�Gl1G
Point of Contact:
Address: l � 1 v u�UD// CAf)c.-e 12 T
0
City,State,Zip:
31
Home Phone: �-y
� 1 Cell Phone:11)
Email Address: v�'lV�����-'���6�G Cce-�
Fax Number
For Profit Organization: Non-Profit Organization: Individual: _
Day and Date Requested: �r�� �'nn� ���.57` ✓�C��,�
Time Requested: AWrJP,m, to: �1d�p-m.(Phis includes set-up and clean-up time.)
n �
Rehearsal Date: i C/ Time: gaaWpm.6pxmm to
City Facility Requested: Gazebo X Fountain Area_ Japanese Garden
Palladium Center Green Caucus Room(t/3)_,(213),Council Chambers
Special Requests: Electricity Fountain Restroom Other
Purpose: 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: