305672 11/28/16 CITY OF CARMEL, INDIANA VENDOR: 00352369
ONE CIVIC SQUARE SUNBELT RENTALS CHECK AMOUNT: $*****2,159.22*
CARMEL, INDIANA 46032 PO BOX 409211 CHECK NUMBER: 305672
9M.... ATLANTA GA 30384-9211 CHECK DATE: 11/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4353099 64642983-001 2,159.22 OTHER RENTAL & LEASES
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
SUNBELT RENTALS ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 409211 IN SUM OF$ CITY OF CARMEL
K
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
ATLANTA, GA 30384-9211 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$2,159.22 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Street Department Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
64642983-001 43-530.99 $2,159.22 1 hereby certify that the attached invoice(s),or 11/4/16 64642983-001 $2,159.22
2201 201 2201 201
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
Tuesday, November 15,2016
Dave Huffman
Director
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
INVOICE
SEND ALL PAYMENTS TO:
SUNBELT RENTALS,INC. , 64642983-001
0PO BOX 409211
ATLANTA,GA 30384-9211
SUNBELT® ACCOUNT NO. 2806565
RENTALS
e e • 11/04/16
PAGE 1 of 1
INVOICE TO RECEIVED BY CONTRACT NO.
1o-1379-1820 CALL, IN 64642983
CARMEL STREET DEPT PURCHASE ORDER NO.
3400 W 131 ST ST
CARMEL IN 46074-8267 REFLECTING POOL
Illnllllnllnlllnlllnllnln�llllllnl11111 lllnulllll JOB NO.
4-CARMEL STREET DE
JOB ADDRESS BRANCH
CARMEL STREET DEPT FISHERS PC394
3400-IN-EST 131ST 11120 ALLISONVILLE RD
WESTFIELD, IN 46074 8267 FISHERS, IN 46038-1837
317-733-2001 317-849-2119
QTY EQUIPMENT# Min Day Week 4 Week Amount
1 SCRUBBER INDUSTRIAL RIDE-ON LPG 705.00 705.00 1855.00 5505.00 1855.00
781057 Make: TENNANT Model: T20 Ser#: T20-6320
HR OUT: 139.000 HR IN: 151.000 TOTAL: 12.000
Billed from 11/02/16 thru 11/04/16
Re ntal Sub- total: 1855.00
SALES ITEMS:
Qty Item number /Unit Price
1 ENVIRONMENTAL EA5.970 25.97
ENVIRONMENTAL
1 RENTAL PROTECTION PLAN �EA.� 278.25
FINAL BILL: 11/02/16 11:08 AM THRU 11/04/16 12:48 PM:' y,
r
Equipment. Service. Guaranteed. SUBTOTAL 2,159.22
REMIT TO:
SUNBELT RENTALS, INC. NET DUE UPON RECEIPT PONa 2,159.22
PO BOX 409211 Invoices not paid within 30 days may be subject
ATLANTA,GA 30384-9211 to a 1-1/2%per month charge.
DGAITAI DGTIIDAI
Page 1 of 1
SUMBELT®
RENTALS
PC#: 394 SUNBELT RENTALS, INC.
11120 ALLISONVILLE RD
FISHERS, IN 46038-1837
317-849-2119
Job Site: RENTAL RETURN
CARMEL STREET DEPT III IIIIIIIIIIIIIIIIIIIIIIIIIIII III
3400 WEST 131 ST
WESTFIELD, IN 46074 8267
Invoice #... 64642983-001
C#: 317-733-2001 J#: 317-733-2001 Invoice date 11/04/16
Date out.... 11/02/16 1 1:08 AM
Customer: 2806565 Date in..... 11/04/16 12:48 PM
CARMEL STREET DEPT._ - --- --- Job Loc..... 3400 WEST 131ST, WESTFIELD
3400 WEST 131 ST Job No...... 4 - CARMEL STREET DE
WESTFIELD, IN 46074 P.O. #...... REFLECTING POOL
Ordered By.. CALL, IN
NET DUE UPON RECEIPT
QTY EQUIPMENT # Min Day Week 4 Week Amount
1.00 SCRUBBER INDUSTRIAL RIDE-ON LPG 705.00 705.00 1855.00 5505.00 1855.00
781057 Make: TENNANT Model: T20 Ser #: T20-6320
SCRUBBER RIDEON,TENNANT,T20,LPNG
HR OUT: 139.000 HR IN: 151.000 TOTAL: 12.000
Billed from 11/02/16 thru 11/04/16
Rental Sub-total: 1855.00
SALES ITEMS:
Qty Item number Unit Price
1 ENVIRONMENTAL EA 25.970 25.97
ENVIRONMENTAL
RENTAL PROTECTION PLAN 278.25
Sub-total: 2159.22
Total: 2159.22
FINAL BILL_: 11/02/16 -11:08 AM.THRU 11/04/16 12:48 PM.
11 amounts are in USD
* Rate our rental ex erit:nce www.sunbeltrentals.com/surve *
PROPERLY,IF THE EQUIPMENT DOES NOT WORK MULTIPLE SHIFTS OR CUSTOMER IS RESPONSIBLE FOR
. OVERTIME RATES MAY APPLY REFUELING,DAMAGES
1. The total charges are an estimate based on the estimated rental period and other information provided by Customer.
2. Customer assumes all risks associated with the Equipment during the Rental Period,including injury and damage to persons,property and the Equipment.
3. Customer is responsible for and shell only permit properly trained,Authorized Individuals to use the Equipment.
4. If the Equipment does not operate properly,is not suitable for Customer's intended use,does not have operating and safety instructions or Customer hes any questions regarding use of the Equipment,Customer shall not use the Equipment and
shell contact Sunbelt immediately.
5. Equipment misuse or using damaged or malfunctioning Equipment may result in serious bodily injury or death and Customer agrees that Customer(i)assumes all risk associated thereunder,and III)indemnifies Sunbelt Entities for all claims or.
damages as a result of misuse or use of damaged or malfunctioning Equipment.
6. Customer has received,read,understands and agrees to the estimated charges and all the terms an this page,plus all sections on the reverse side of this Contract rsections7,including Release and Indemnification in Section 8 and Environmental
Fee in Section 16,which can also be found at www.sunbeltrentels.comirentalcontract.•DeliverylPickup Surcharge fee explanation is available at www.sunbeltrantals.eomisurcharge.
7. Customer must contact Sunbelt to request pickup of Equipment,retain the Pick-Up Number given by Sunbelt and will be responsible for Equipment until actually retrieved by Sunbelt.
8. Customer waives its right to a jury trial in any dispute as set forth in Section 19.
9. At the election of Sunbelt or Customer,Customer agrees to submit every dispute to arbitration and waives any right to bring a class action as set forth in Section 20.
Customer' clivi R t otectCCon Plan(see averse side for details)_IC stamer Initials)
Customer Signature Date Name Printed Delivered By Date
••www.sunbeltrentals.com•• RNTRET2P IRov 11/10/15)