HomeMy WebLinkAbout332563 11/21/18 1y p�C�yMf
CITY OF CARMEL, INDIANA VENDOR: 372930
.�, ® ,• ONE CIVIC SQUARE NORTHVIEW.CHURCH
CHECK AMOUNT: $********75.00*
CARMEL, INDIANA 46032 12900 HAZEL DELL PARKWAY CHECK NUMBER: 332563
C/O AUDRA KELLY CHECK DATE: 11/21/18
CARMEL IN 46033
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4359029 SAM BURGESS 75.00 HISTORIC PRESERVATON
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
Vendor# 372930 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
NORTHVIEW CHURCH IN SUM OF$ CITY OF CARMEL
12900 HAZEL DELL PARKWAY An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
C/O AU DRA KELLY rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
CARMEL, IN 46033
Payee
$75.00
ON ACCOUNT OF APPROPRIATION FOR
Purchase Order#
Dept of Community Service Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
Sam Burgess 43-590.29 $75.00 1 hereby certify that the attached invoice(s),or 10/25/18 Sam Burgess Rental of Chapel in Northview Church for $75.00
1192 101 1192 101 Committee meeting
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
Wednesday, November 14,2018
Mike Hollibaugh
Director
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have
audited same in accordance with IC 5-11-10-1.6
, 20—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
northviewchurch
FACILITIES I PROPERTY USE AGREEMENT
Campus: C.drm-e I 1a loo 14a r D-el l' Pari wa
PURPOSE:'This Agreement gives permission'to groups,organizations and individuals("User")not directly overseen by
Northview Church to use specified facilities and property owned by the church. Users with the permission of Northview
Church do so with full knowledge that losses or liabilities incurred by the User are not covered by the church. The User
will be totally responsible for any/all damages/injuries that may occur during their time using the facilities/properties.
This Agreement is entered into on this 5� day of 0er of the year by and-
between Northview Church and
Name of User/contact person Z U 1✓S1
Address of User/contact person I?xA CF-Waf'.-A , A-VG N�JANa1 i,rf� / LM 6'7.v`a
E-mail of User/contact person 6u ;viA ("^-.,v
Phone#of User/contact person
Facility area desired �f 4�l ( Lh A rym
Date(s) Requested 1 �'�. Z(� J` / �•&'o 3 n
Anticipated Attendance 0 ! 6V
Building Space Requested:
Auditorium
Classroom(s)
Common Space,Kitchen&Cafe
Kids/Student Center
Outside Amenities /
�[
Other: I'h a'4
WHEREAS Northview Church is the owner of building and property located at the address printed above;
AND WHEREAS the User desires to use church facilities/property on the terms and conditions set forth.
NOW,THEREFORE,inconsideration of the mutual promises contained herein(and in separate Agreement—if
applicable),it is agreed by and between the parties to the following:
1. User agrees to release and hold Northview Church harmless from any and all injury and liability including attorney's
fees arising out of the Users use of the above premises or the building(s)of which the facilities are a part,and or any
parking facilities on or adjacent thereto.
2. The user understands that the responsibility to obtain liability and property insurance is upon the User. It is not the
duty or responsibility of Northview Church to insure the User's use of facilities. Insurance. User agrees to list Northview
Church as an Additional Insured(AI)on its General Liability Policy,providing the church with a Certificate of Insurance
showing this status,and a General Liability limit of no less than$1,000,000 per Occurrence for bodily Injury and property
damage,and if User has employees, proof of Workers Compensation on said Certificate.
A i
These insurance requirements do not apply if Northview Church Representative initials so here !
3. The User agrees to abide by and obey all laws,ordinances,and regulations promulgated by any government unit
having jurisdiction in the locale of Northview Church and will not engage in any activities in violation of such laws,
ordinances, rules and regulations.
4. User agrees to abide by any rules or regulations for the use of the premises.
5. The User takes on the responsibility of every and all actions of any and all ages of the participants of the
event/activity.
PRICING:
Building Fees(Mark the left box for the appropriate fees,if no charge,please enter N/C)
$ Auditorium/Sanctuary $
$ Classroom(s) $50
$ Common Space,Kitchen,Cafe $50
$ Kids/Student Center $50
$ Outside Amenities $50
$�— Other: $ U
Owner and User agree that the use of the
facilities/property is at NO charge.
Custodial Fees(Mark the box at the left for the appropriate fees)
This is a non-refundable fee to be returned with this signed agreement and the reservation is officially made.
$ 3 hours or less($25/hour)
$ $75 Half day(up to 4 hours)
$ $125 Full Day
6. Billing: We understand Northview Church will invoice the User for the $ _75', 01' in building and custodial
fees
2ha (3h, VYL-_ lo- _-lg
(Signature of Northvle Church Rep entative) Date
(Signature of User Contact person) Date
I-A DL. 5'_A1V1,U 5t_
(Print name of User/Contact Person) rev. 7-25-2018