HomeMy WebLinkAbout209295 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 365308 Page 1 of 1
ONE CIVIC SQUARE PAN USA LLC CHECK AMOUNT: $185.00
CARMEL, INDIANA 46032 3714 SIMS LANE
BLOOMINGTON IN 47403 CHECK NUMBER: 209295
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4340800 185.00 ADULT CONTRACTORS
PanUSA LLC
Entertainment 20 12
Application is hereby made by the undersigned CLIENT this 15 day of AVt 294-1- for the purposes of
public /private performance with equipment and services described below:
The base fee includes: Musical /educational performances as requested. Pre -event coordination and logistics and details.
Up to (1.0) hour /s with 1 performers. (Requested additional hours BEYOND 1 hour /s will result in $50.00 monetary
compensation per half hour per member to be negotiated on -site)
-1 Steel Drum Performer /vocalist
Base Fee: $185.00
Deposit due:$20.00
Additional Expenses: $.00- travel
Balance $165.00 due on -site or prior to engagement
Event Information
6/15112
Contact: Name of event DAY contact: Jennifer Hammons
PH# Day Of# M c�
Mailing Address: a3 C
Caciy)C 1 lu C�Z
Performance Space Address: &5 ;1 2 (m N) fe'A t
(must have access to power and out of direct sunlight) Z
Event Time: (up to 1.0 hours) 2:00 -3:00 PM
Payment Information
-For the above, the undersigned will pay a base fee of: $185.00
Deposit of ($20.00) will be due within 15 calendar days of receipt of the contract.
Deposit is refundable up to 72 hours of event date.
-Upon acceptance and approval of this application, remaining balance, ($165.00) will be due on -site prior to fore mentioned
'event'.
-In the event of foreseen and unforeseen weather related events payment agreement will remain intact.
Payment in partial or full shall be made as Check, Money Order or Cash.
Credit Card Payments are also accepted... please contact PanUSA for CC payment details.
This agreement should be signed and submitted, no later than_04/15/12_. After this date, staff ing /equiptment/shipping /travel
and pricing adjustments may impact this program.
All remittance and payments should be made payable to:
PanUSA LLC
3714 Sims Ln
Bloomington IN 47403
It is understood that the undersigned Client acknowledges and agrees with the Terms and Conditions
accompanying this agreement. It is also understood that an original of this agreement is legally binding to both
parties.
Tom Berich
Au d presentative (Client) Authorized Representative
Tom Bei-ich- PanUSA
Electronic Signature Electronic Signature
Purchase G
please sign and return to: panusa @mac.com or f to 801- 382 -2 403 Description
P.O. e oO(n 5 P o
1 7
G. L.# I
Budget
MAY 1 5 7012 Una Descr i
E
Purchaser r Date
Mrr. Approv Dat -j i -2—
Carmel oCla
y
Parks &Recreation CHECK REQUEST
Date: C�
Check payable to
S r
Name: J
Gtl o
Address:
City, State, Zip C,v0 O \'41V 6
Mail check to payee V Return check to requestor
(yj
Check Amount Date Required V`'1C t C
Check needed for: C 0 ck'�
To be paid from
PO (if applicable) 6 0
Budget account GL
Budget Line Description y C \1 O k
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): \1 Ac 1'1 r n 00
Requested by (signature): \I1 C�IX 1 lIE
Approved by (signature of Division Manager):
on this date
Form revised 7 -7 -08
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.
365308 Pan USA LLC Terms
3714 Sims Ln
Bloomington, IN 47403
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/15/12 Contract Creekside Vacation Station 6/15/12 185.00
Total 185.00
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.
365308 Pan USA LLC Allowed 20
3714 Sims Ln
Bloomington, IN 47403
In Sum of
185.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1082 -1 Contract 4340800 185.00 1 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
17 -May 2012
Signature
185.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund