333277 12/11/18 CITY OF CARMEL, INDIANA VENDOR: 363882
ONE CIVIC SQUARE MIKE AINLEY CHECK AMOUNT: $**.....100.00*
CARMEL, INDIANA 46032 1474 CLEARWATER CT CHECK NUMBER: 333277
CARMEL IN 46032 CHECK DATE: 12/11/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GAZEBO 100.00 OTHER EXPENSES
VOUCHER NO. WARRANT NO.
_ 1A- t-ie
ALLOWED 20
1�1 i ICe ,4i n l� �j�0�
`-�M IN SUM OF $
1414 0e-CX rW CLAex�' CTU
Cacrnel, J Y4
$ 100
—
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT I hereby DEPT.# y certify that the attached invoice(s),
10 1 50 IGn 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
t Charlie Driver
CITY OF CARMEL ;)
, w
Adam Harrington
3 FACILITY USE REQUEST FO: nil a P Pr,,a 1 s v i u e►mom 1
Name/Organization: 1tAn.
Air^ �0�� Ce. 14""er'
r J, Point of Contact: %K9
. Address: FA
C°i' 'e'�
City,State,Zip: ( 2.m � 1 IJ
Home Phone:
Email Address:
.. .� ��i.�`t 2 Fax Number
Non-Profit Organization: Individual:
For Profit Organization: g � s .;
Day and Date Requested: s�
Time Requested: P.M. to: ti:30 a•R►✓� (This includes set-up and clean-uptime.)
Rehearsal Date: r
Time: a.mJp.m. to a.m./p.m.
ebo tom' Fountain Area V Japanese Garden
City Facility Requested: Gaz
Palladium Center Green Caucus Room (1/3)_(2/3)_Council Chambers
Special Requests: Electricity V Fountain Restroom V Other
Purpose: Number of People Expected: _"� „.
Vendors: Yes_ No I (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: tjo
1 N�:
Neighborhood Street Closing(Street(s),Address(es)Blocked) i
ole scrion,to den
The Carmel Board of Public Works and Safety reserves the right,in its Buse a Ci a facility fort'
any facility use request and/or revoke any previously granted request to ty
any lawful reason.
Received this day of ,201
�s
Mayor's Office Revised: 01/22/16
Id"(v-1s
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
�i/� Payee
Mile- �"'/� (� -'q Purchase Order No.
Ham i zrn C,)- Gro P Wo 1�.
Terms
q,Gr Wo ;r G
tarm'L, )t-A ' -Co 03 a Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Ze use, ,e�h.d ��'�' I 100
oS.�
Total 00 —'
I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer