DOC1736992151.pdf

Procure-to-Pay

3835 Holdrege Street | Lincoln, NE 68583-0742 | 402.472.2126 nebraska.edu/p2p

University of Nebraska Contract Summary

CONTRACTOR/COMPANY INFORMATION

Supplier EUGENE T MAHONEY STATE PARK Contact David

Sourcing Agent Email Ngpc.mahoney.functions@nebraska.edu

REQUESTING DEPARTMENT

Participating Campuses

UNMC

Administrative Unit/Dept.

Department Contact Jenelle Pomicter

CONTRACT DESCRIPTION/INFORMATION

Contract Summary (brief description and/ or event name)

Rental of conference room at Mahoney State Park .

Contract Document Document Amt Total Amt Start Date End Date Notes

CW 36884 $99.00 11/04/2025 11/04/2025

COMPETITION/BID INFORMATION

Bid Number

Competition Under $50k

Contract Information

INTERNAL USE ONLY

Contract ID CW36884

Eugene T. Mahoney State Park 28500 West Park Hwy. Ashland, NE. 68003-3508

Phone: 402-944-2901 / Fax: 402-944-7604 Email: ngpc.mahoney.functions@nebraska.gov

Peter Kiewit Lodge Conference Rooms

Abel Nebraska Room Red Oak Room Cedar Room

Sandstedt Platte Room Blue Agate Room Prairie Agate Room Goldenrod Room Cottonwood Room

Confirmation Event Date: Arrival Date _______________ Departure Date _______________

Your ___deposit___ payment amount of $_________ is due by _________. This amount includes the reservation fee [$8.50 plus tax, if applicable, per room]. Please sign and return this page with your advance deposit in the amount shown above. If the above amount is not paid by the due date, your reservation will be cancelled.

YOUR CREDIT CARD/PAYMENT AMOUNT OF $______________ has been processed.

*Tax Exempt Form 13 is enclosed. Please complete and return this to the Group Functions Department.

Park Rental Terms and Policies: Please initial each line item.

Rental of the Peter Kiewit Lodge Conference Room(s) includes: tables, chairs, basic set-up/tear-down, trash bins, trash removal, and use of AV equipment (upon request).

The rental period for the Peter Kiewit Lodge Conference Room(s) is from 8:00am – 10:00pm. Park quiet hours begin at 10:00pm.

Amplified music, dance floors, candles/open flames, hot plates/electric trivets, confetti, glitter, sequins, silly string, poppers, and balloons, etc., are prohibited in the Peter Kiewit Lodge Conference Room(s).

Any additional decorations need prior approval before being placed. Chafing dishes used by catering companies are permitted.

Cancellation Policy: Should you find it necessary to cancel the Peter Kiewit Lodge Conference

Room(s), a refund of your deposit (less the reservation fee and cancellation fee) can be made if you notify the Group Functions Department (in writing) 30 days or more in advance. Should you find it necessary to cancel this event closer to your event date (inside 30 days), your deposit/payment will be forfeited. Refunds must be made using the same method of payment.

Carl’s at Mahoney is the on-site caterer available for events at Mahoney State Park. Please coordinate group dining and catering options through the restaurant. Please give Diane Kucera a call at 855-446-2202. Outside food is allowed if you do not want to go through the restaurant.

If your event includes overnight lodging accommodations, a rooming list with primary occupants will be required at minimum 72 hours prior to check-in. Overnight lodging check-in is at 4:00pm.

Check out is 11:00am.

Group Functions Department will contact you up to 10 days prior to discuss room set-up. Any set-up changes, AV equipment, or equipment requests inside 5 days may result in additional setup fees.

Due to fire code, we cannot seat more than our set up guides will allow.

X X 98.50

X

November 4, 2025 November 4, 2025

October 3, 2025

If damages, excessive trash, or failure to keep the venue space as it was when the representative took possession of the space occur, the park will assess the situation, and additional fees may be incurred.

A valid Park Entry Permit is required by state law for all vehicles entering the Park. Park entry permits are available at the park entry kiosk, the administration office, or at the Peter Kiewit Lodge.

Please inform the members of your group of this fee.

Only registered service animals are allowed in the building.

Nebraska State Parks prohibit alcohol consumption in parking lots, roadways, on trams and trolleys, or any building open to the public as required by State Law. Persons reserving the facilities are responsible for the conduct and deportment of their guests. Service to minors or those guests who are visibly intoxicated will be refused. Please see the Park’s alcohol policy.

We look forward to having you visit Eugene T. Mahoney State Park and hope you enjoy your stay. If you have any questions or need assistance, please contact the Group Functions Department.

Please sign below as an acceptance of the enclosed confirmation and the above-stated policies and return, With any payment due to the Group Functions Department.

Thank you.

PRINT NAME: _________________________________

Signature __________________________________________________ Date ___________________________

FOR PARK USE ONLY:

EVENT ID #___________________________________

GROUP NAME: ________________________________

DATE OF EVENT: ______________________________ November 4, 2025

CS-Cash Meeting 616794564

09/29/25 | 10:27 CDT

09/29/25 | 17:04 CDT

Michael Hrncirik

Certificate Of Completion Envelope Id: C95E4012-3301-4627-8E39-5E7432C5FD03 Status: Completed

Subject: CW36884 - Mahoney State Park Nov 2025

Source Envelope:

Document Pages: 3 Signatures: 1 Envelope Originator:

Certificate Pages: 5 Initials: 1 Melody Stark

AutoNav: Enabled

EnvelopeId Stamping: Disabled

Time Zone: (UTC-08:00) Pacific Time (US & Canada)

1400 R Street

LINCOLN, NE 68588

melody.stark@nebraska.edu

IP Address: 35.223.106.21

Record Tracking Status: Original

9/29/2025 10:23:59 AM

Holder: Melody Stark melody.stark@nebraska.edu

Location: DocuSign

Signer Events Signature Timestamp Pam Ehmke pehmke@unmc.edu

Assistant Dean of Finance

College of Public Health

Security Level: Email, Account Authentication (None)

Signature Adoption: Pre-selected Style

Using IP Address: 192.94.102.1

Sent: 9/29/2025 10:26:07 AM

Viewed: 9/29/2025 10:27:10 AM

Signed: 9/29/2025 10:27:22 AM

Electronic Record and Signature Disclosure:

Accepted: 9/29/2025 10:27:10 AM ID: 48830cc3-ac34-43e6-9196-a72f7c44fa37

Michael Hrncirik mhrncirik@unmc.edu

Assistant Vice Chancellor for Business F

University of Nebraska Medical Center

Security Level: Email, Account Authentication (None)

Signature Adoption: Pre-selected Style

Using IP Address: 192.94.102.0

Sent: 9/29/2025 10:27:23 AM

Viewed: 9/29/2025 5:04:36 PM

Signed: 9/29/2025 5:04:48 PM

Electronic Record and Signature Disclosure:

Accepted: 9/29/2025 5:04:36 PM ID: 18ab81b8-36e6-4276-89f1-36ca165b0c7d

In Person Signer Events Signature Timestamp

Editor Delivery Events Status Timestamp

Agent Delivery Events Status Timestamp

Intermediary Delivery Events Status Timestamp

Certified Delivery Events Status Timestamp

Carbon Copy Events Status Timestamp Jenelle Pomicter jpomicter@unmc.edu

Security Level: Email, Account Authentication (None)

Sent: 9/29/2025 10:26:06 AM

Viewed: 9/29/2025 10:27:46 AM

Electronic Record and Signature Disclosure:

Accepted: 8/22/2024 7:47:11 AM ID: 0dcf321d-5c3c-4672-88fb-d5e6531498d1

Carbon Copy Events Status Timestamp David

Ngpc.mahoney.functions@nebraska.edu

Security Level: Email, Account Authentication (None)

Sent: 9/29/2025 5:04:49 PM

Electronic Record and Signature Disclosure:

Not Offered via Docusign

Melody Stark melody.stark@nebraska.edu

Sourcing Agent

University of Nebraska

Security Level: Email, Account Authentication (None)

Sent: 9/29/2025 5:04:49 PM

Electronic Record and Signature Disclosure:

Accepted: 11/13/2023 10:42:36 AM ID: f6be8008-ef45-4d6e-b4e3-5c6f95447db3

Witness Events Signature Timestamp

Notary Events Signature Timestamp

Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 9/29/2025 10:26:06 AM

Certified Delivered Security Checked 9/29/2025 5:04:36 PM

Signing Complete Security Checked 9/29/2025 5:04:48 PM

Completed Security Checked 9/29/2025 5:04:49 PM

Payment Events Status Timestamps

Electronic Record and Signature Disclosure

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Electronic Record and Signature Disclosure created on: 5/16/2023 6:53:28 PM Parties agreed to: Pam Ehmke, Michael Hrncirik, Jenelle Pomicter, Melody Stark

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