HomeMy WebLinkAbout325328 05/23/18 VOUCHER NO. WARRANT NO. -J 0%r^1 G
ALLOWED 20
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Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
/O i 5oa 39c10 /00 — or 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
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Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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Approvals/Date
Nancy Heck
CITY OF CARMEL Charlie Driver ak
FACILITY USE/EVENT REQUEST FGAdam Harrington
Name/Organization: Whalen Abbott&Jodie Harper
r
Point of contact: Whalen Abbott
Address: 1326 Beacon Way
City,State,Zip: Carmel, IN 46032
Home Phone: (317)753-7943 Cell Phone:( ) Same
Email Address: wabbott@alro com Fax Number ( )
For Profit Organization: Non-Profit Organization: Individual: xx
Day and Date Requested: Suri May 101h 2018
Time Requested: —2 pm_a.m./p.m. to: _9pm a-m-/p.m. (This includes set-up and clean-up time.)
Rehearsal Date: Time: a.m./p.m./noon to
a.m./p-m./midnight.
City Facility Requested: Sophia Square Fountain Area
Palladium Center Green Caucus Room (1/3)_(2/3)_Council Chambers
Special Requests: Electricity Fountain Restroom Other
Purpose: Nedding Number of People Expected: 40
Vendors: Yes_ No_x_(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) _None
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_6th_day of Feb . 2018.
Aeyor'S Office
Revised: 01/22/16
ACKNOWLEDGEMENT AND AGREEMENT
TO COMPLY WITH CITY FACILITY USE POLICY
I have read and understand the City of Carmel,Indiana("City")Facility Use Policy and agree to be bound by all the
terms and conditions set forth therein.
will leave the City facility I use in the same condition that it was immediately prior to my use thereof. I agree to pay
for any damage,repair or clean-up costs incurred by the City as a result of my use of a City facility.
I hereby certify that I,and the organization I represent,if applicable,agree to be bound by the City's Facility Use Policy
and by any addition conditions or restrictions placed upon my/our use of a City facility by the Board. I understand that
the Board has the right to deny,alter or revoke my request for the use of a City facility for any lawful reason. I and/or
my organization also agree to indemnify and hold harmless the City of Carmel and all of its directors,officers,
employees,agents and affiliates from any claims of whatever nature(whether foreseeable or not)arising from or in
connection with this Application for any damages,costs or expenses incurred directly or indirectly as a result of my/our
use of the City-owned facility and/or property.
Please sign below and deliver or mail the completed form to the City of Carmel.Attn: Lobbv Reception Desk One Civic
Square.Carmel Indiana 46032 -
Approved this day of 201 .
CITY OF CARMEL,INDIANA
_Whalen Abbott By and Through its Board of Public Works and Safety
Name of Organization/Applicant
Signature of Authorised Agent/ es Brainard,Presdi g Offic
Applicant D te:
Printed Name and Title(If applicable) Mary Ann B ke,Mer►}t�er p
Date:
132& RUMI WAy ( L
Address of Organization/Applicant Lori Wa son, emr
Date—
Date: 2/6/2018
7
ATT T:
ristine S.Pauley,Clerk-Tr asurer /
Date:
Special Conditions:
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