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181797 02/03/2010 CITY OF CARMEL, INDIANA VENDOR 360668 Page 1 of 1 s ONE CIVIC SQUARE ASCAP CHECK AMOUNT: $731.00 V. 4 CARMEL, INDIANA 46032 21678 NETWORK PLACE 0 CHICAGO IL 60673 -1216 CHECK NUMBER: 181797 CHECK DATE: 213/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4358300 2993126 731.00 OTHER FEES LICENSES 2675 Paces Ferry Road, SE, Suite 350 Page: 1 of 1 r Atlanta, GA 30339 `1 1 Attn: Account Services Atlanta i�LYYI� (Ve- Phone: 1- 800 505 -4052 on TA tkt 1— —t Fax: 1- 770 805 -3475 AS C A P 0 1 W Mark Westermeier Purchase A,, M c I, Re: Carmel Clay Dept Of Parks Recreation o *7 Director Of Parks D�� tlon Carmel Clay Dept Of Parks Recreation a Carmel Clay Dept Of Parks Recrr�io NI# 1411 E 116th Street 1411 E 116th Street IN 46032 -3455 Carmel, IN 46032 -3455 JQ.L I0°I1 43j 83vo IO�7_ t ©0 °IDD Line °it.J Re..„) (2 c -cn.N c, Purchaser Approv: A Date I I l3J 2 if You Have Air- d` y Made Payment, Please Disregard This invoice. In Case Of Error lC Amount Of Bill OrPayment, Contract ;aims Shall Govern ACCOUNT NO. BILLING DATE CURRENT PAST DUE M5- S!BALAN,CEMUE,4 500640093 12/20/2009 $731.00 $731.00 $731 00;:: WCONTRACTtRATE4 $731.00 Charges per applicable operating policy and rate schedule "copies available on request MLA e�4..��z 4 w� 2z r� a,,�a a.��� r r�� ts� �t�t,ap A SCAP TR z q a ^5,,,,Se t ,s a ,,`"z y c a:ts„ v ,,t! a p .a y s- x;, r ^5'3= T p, w. Sy M r I x» n�....,a��t "�f`...''� �a �r��i F -.'�c ��w �'3a 4 h^ 'AV c�'' P... a :;l c R w"� d -rb F.k'9. s r! .p, K s c i e r u y, a y K lii ING S .:;.r,, REF,ERENCE NO.e DATE�'w„ .CHECK =NO. "M EXP LFlNATIOWaOF,,CHARGES &;CREDITS r� AMOUNT_,. r REMAINING PREVIOUS BALANCE $0.00 100002993126— J12/2 j License Fee 01/01/2010 to 12/31/2010 $731.00 C $731:00_ Thank you in advance for your timely payment. Please submit reports and payments for Special Events 90 days after the conclusion of each Event. Securely manage your account on line and avoid late fees at: www.ASCAP.com Securely manage your account on line at www.ASCAP.comlgls_web Happy Holidays and Best Wishes for the New Yearlll Page: 1 of 3 LOCAL GOVERNMENT ENTITIES 2010 Rate Schedule and Report Form ASCAP Account No.: 500640093 Premise Name: Carmel Clay Dept Of Parks Recreation; Report Due: 12/30/2010 SCHEDULE A: Base License Fee 4 Base L cease Population S ze gee 1 to 50,000 $305 50,001 to 75,000 $608 75,001 to 100,000 $731 100,001 to 125,000 $975 125,001 to 150,000 $1,219 1.50,001_ _-to 200 $1,584° 200,001 to 250,000 $1,949 250,001 to 300,000 $2,316 300,001 to 350,000 $2,682 350,001 to 400,000 $3,047 400,001 to 450,000 $3,412 450,001 to 500,000 $3,779 500,001 and $4,631 over $4,631 plus $500 for each 100,000 of population above 500,000 to a maximum fee of $60,938 SCHEDULE B: Special Events The rate for Special Events shall be 1°/0 of Gross Revenue. "Special Events" means musical events, concerts, shows, pageants, sporting events, festivals, competitions, and other events of limited duration presented by LICENSEE for which the "Gross Revenue" of such Special Event exceeds $25,000. "Gross Revenue" means all monies received by LICENSEE or on LICENSEE'S behalf from the sale of tickets for each Special Event. If there are no monies from the sale of tickets, "Gross Revenue" shall mean contributions from sponsors or other payments received by LICENSEE for each Special Event. SCHEDULE C: State Municipal and/or County Leagues or State Associations of Attorneys The annual license fee for LICENSEES who are legally organized as state municipal and /or county leagues or state associations of municipal and /or county attorneys shall be $305. License Fee for Year 2011 and Thereafter For each calendar year commencing 2011, all dollar figures set forth in Schedules A, B and C above (except for $500 add -on for populations of 500,001 or more) shall be the license fee for the preceding calendar year, adjusted in accordance with the increase in the Consumer Price Index All Urban Consumers (CPI -U) between the preceding October and the next preceding October. Any additional license fees due resulting from the CPI adjustment shall be payable upon billing by ASCAP. Page: 2 of 3 LOCAL GOVERNMENT ENTITIES 2010 Rate Schedule and Report Form ASCAP Account No.: 500640093 Premise Name: Carmel Clay Dept Of Parks Recreation; Report Due: 12/30/2010 SCHEDULE A: Base License Fee (Due upon execution of Agreement and within 30 days of the Agreement's Renewal Date.) Population Size: 1 Base License Fee: 7 31. d (Per current U.S. Census Data) (Please refer to attached Rate Schedule) SCHEDULE B: Special Events* (Report and Payment due 90 days after the conclusion of each Special Event) I• E vent Date fi Yis 4 t k F3 rrs t Ex w F s s s i mmlddi 6 tik 3 n�+�£.,t PA, v p z v r4tt t Zr e cy -,..s €`t� (r f C7r055 n�" �r rs ,s'� If7`More thanrl s� Revenue of s y t ,�u# tt L g =.F sf Wait w y k s s t 1 E _vent Per' Da �F yi Event z 5 f �f t" 3 t+ .k�` z r le; program of �r s CO Sponsojed r a c li tYa a s i5 o f iC y s H ,rN Please Report 3 Kra fir (Mu st Applies Musical Works (Plea�se Identify The Y. ..r P x F s Pone *s Separate, P Performer(s) orµ Exceed to Gross Attached' Co s onsor s Name Addres a`� ygw:' x;.�' .�W r. sue, d mss; r� n,i.,: i Entries G roup(sj°Appearin g 3. $25000) _fie: ,Revenue a vent Fee< (Yes /No) :=1: Num ber 'and!ASCAP'Account -Number) Name: Address: x .01 Phone No.: Account No.: Name: Address: x .01 Phone No.: Account No.: Name: Address: x .01 Phone No.: Account No.: Name: Address: x .01 Phone No.: Account No.: "Special Events" means musical events, concerts, shows, pageants, sporting events, festivals, competitions, and other events of limited duration presented by LICENSEE for which the "Gross Revenue” of such Special Event exceeds $25,000. 'Gross Revenue" means all monies received by LICENSEE or on LICENSEE'S behalf from the sale of tickets for each Special Event. If there are no monies from the sale of tickets, "Gross Revenue" shall mean contributions from sponsors or other payments received by LICENEE for each Special Event. ASCAP, 2675 Paces Ferry Road SE, Suite 350, Atlanta, GA 30339 -3913 1- 800 -505 -4052 770 -805 -3475 (FAX) Epayment Websites: http:I /www.ascap.com /gls_web or http:I /www.ascap.com Report Form Continued On Reverse Side Page: 3 of 3 LOCAL GOVERNMENT ENTITIES (continued): (Please complete form in its entirety.) SCHEDULE C: State Municipal and/or County Leagues or State Associations of Attorneys Report Year: Annual License Fee: $305.00 (Due within 30 days of Renewal Dale.) Total Fees Reported From Any or All of Schedules A, B or C: 13 0 o Base Licensee Fees accompanied by:a completed Report Form are due;and payable within 30idays of the License Agreement's'renewal date. The Reporf along with payment may be mailed to the ASCAP address below Contact Person: t tkL ca.J 110 (Please print Contact's' fume.) (Please print Contact's Title.) Phone No.: (311 S73-4 OR. Fax No.: (3I1 STt. 413i.. Email: M� xn� Q� Website: Jo (c/ ka ti I certify that the above information is true and correct. Signature: Dated: O 133 f t a se print Name and Title of Signature name above.) ASCAP, 2675 Paces Ferry Road SE, Suite 350, Atlanta, G 30339 -3913 1- 800 -505 -4052 770 805 -3475 (FAX) Epayment Websites: http:llwww.ascap.comlgls_web or http:Nwww.ascap.com 12/20/2009 F0166_0110 ter+ ASCAP Account No.: 500640093 Carmel Clay Dept Of Parks Recreation ASCAP IMLA 1411 E 116th Street Account Services Carmel, IN 46032 -3455 2675 Paces Ferry Road SE Suite 350 Atlanta GA 30339 -3913 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Payee Purchase Order No. 360668 ASCAP Terms 21678 Network Race Chicago, IL 60673 -1216 Invoice Invoice Description Date Number or note attached invoice(s) or bill(s)) PO Amount 731.00 12/20/09 100002993126 License to rebroadcast music Total 731.00 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 Clerk- Treasurer Voucher No. Warrant No. 360668 ASCAP Allowed 20 21678 Network Place Chicago, IL 60673 -1216 ,Att In Sum of 731.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or Board Members INVOICE NO. ACCT #/TITLE AMOUNT Dept 1091 100002993126 4358300 731.00 !hereby certify that the attached invoice(s), 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 28 -Jan 2010 §/7), Signature 731.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund