WVIF&E
PO Box 361
Mineral Wells, WV 26150
(304)489-1301 FAX (304)489-3136
Contracting Party: _____________________________________________
Contact Person: _________________________
Phone Number: _________________________
Rental Dates: _________________________
Commercial Building: ________ Days @ $275.00 Total __________
Kitchen Added ________ Days @ $125.00 Total __________
Main Shelter: ________ Days @ $125.00 Total __________
4-H Building: ________ Days @ $125.00 Total __________
Open Shelter: ________ Days @ $125.00 Total __________
Pifer Shelter: ________ Days @ $50.00 Total __________
Camping Fees: ________ Days @ $15.00 w/electric Total __________
________ Days @ $8.00 primitive Total __________
Meals Provided By WVIF&E:
Meals Per Day: ________ @ $________ Per Meal Total __________
Tables Provided By WVIF&E:
Tables: ________ @ $3.00 Per Day Total __________
Chairs: ________ @ $1.00 Per Day Total __________
Misc. Grounds: ________ @ $________ Per Day Total __________
Trash Pick-up: $25.00 Per Rental Total __________
TOTAL: ______________
LESS DEPOSIT: ______________
BALANCE DUE: ______________
*** The Deposit Is Non-Refundable Within 30 Days of the Event
