327947 07/25/18 CITY OF CARMEL, INDIANA VENDOR: 372631
ONE CIVIC SQUARE ALESIA COX CHECK AMOUNT: $*******100.00*
r. � CARMEL, INDIANA 46032 1823 ASHLEY WOOD DR. CHECK NUMBER: 327947
APT.6 CHECK DATE: 07/25/18
WESTFIELD IN 46074
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GAZEBO 100.00 OTHER EXPENSES
VOUCHER NO. WARRANT NO.
Me-510'. Co>e *- 3ga&3I ALLOWED 20
t$ a 3 �b�ti>'� �bo� p�'� ��Jf•(o IN SUM OF $
$_ l00-
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
5oa 3 S5 o /06— or bill(s) is (are) true and correct and that
the materials or services itemized thereon
for which charge is made were ordered and
received except
20l�
c
Signature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
A01 � Approvals/Date
Nancy Heck
CITY OF CARMEL Charlie Driver
Adam Harrington
FACILITY USE REQUEST FOR ___.-_
C
Name/Organization: � �' ��o� W.-��S -�2 �..�SX
Point of Contact:
Address: 02.3 ti S� Uad r0
City, State,Zip: 1&Q
Home Phone: ( 1 Cell Phone: (31
Email Address: 6,- g G o:•• e-OM Fax Number
For Profit Organization: Non-Profit Organization: Individual:
Day and Date Requested: o, LS 93 oZ0
Time Requested: a.m. to: a.m./This includes set-up and clean-up time.)
Rehearsal Date: 1$ Time: a.m. to a.�
City Facility Requested: Gazebo Fountain Area Japanese Garden
Palladium Center Green Caucus Room (1/3)—(2/3)_Council Chambers
Special Requests: Electricity Fountain Restroom _ Other
Purpose. rw Number of People Expected: �b
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 ,201
Mayor's Office
Revised: 01/22/16