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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