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311706 05/30/17 9�.C�qy "�>^. ', CITY OF CARMEL, INDIANA VENDOR: 370683 ONE CIVIC SQUARE FRANKLIN EQUIPMENT, LLC. CHECK AMOUNT: $ .....265.00* CARMEL, INDIANA 46032 4141 HAMILTON SQUARE BLVD CHECK NUMBER: 311706 M�rue GROVEPORT OH 43125 CHECK DATE: 05/30/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 5300790 265.00 OTHER EXPENSES � . @ . � E ) e � E a ) m 0 ] � . } } .613. ` . U. ) O f W CO _e ) . Q 2 ) ! � S o } IX ® 2 © O ~ } _ LLO E \ Ix L. a � C 2 7 . ZV ® 0 ® @ W � R § ® , y - a. Q ƒ \ . Z O � « } CY 0 O 2 > } w Z ® ¥ k 2 W CL E R k k Q co Z j ® QLO a . . 0 z © £ \ m U- v 0 a . U 2 IIIINI —ANN Franklin Equipment - Indianapolis INVOICE # 5300790 1921 S. Kentucky Ave. INDIANAPOLIS, IN 46221 MrALMSALas 317 686-0996 Eric Benjam Entered by EB on 05-11-17 INVOICE - CHARGE ACCOUNT - EMAIL CARMEL WASTE WATER TREATMENT • 317 571-2634 ESSED x ATTN: ACCOUNTS PAYABLE 317 571-2636 . ON k 9609 HAZEL DELL PARKWAYMVER;S ' 05-11-17 TNT)TANAPnLTS_ IN 46280 LICENSE • SAME • • • • UNIT EXTENDED RTN 8102-577126 SERIAL # 24310956 1 Submersible Pump 2" Electric 265.00 265.00 Make: WACKER Model: PS2 500 Year: 2016 Dealeragrees to waive certain damages and loss claims against Customer,which are provided for on the reverse side of this contract,in consideration of the following: SUB TOTAL 265.00 A. Customer shall pay a fee of _____-0,,of gross rental charges or$_ per day,or B. A valid certificate of insurance is provided Dealer prior to the hire of equipment.whereby Dealer is named an additional TAX EXEMP # (BELOW) insured on an insurance policy,covering the risk of loss by damage,death or otherwise,of the subject equipment and said insurance being the primary coverage as against any other insurance which may be provided by Dealer. ON FILE DAMAGE WAIVER DECLINED: - - _ INIT. GRAND TOTAL 265.00 1 HAVE READ AND I AGREE TO THE CONTRACT TERMS ON THE BACK OF THIS DOCUMENT.THOSE TERMS CONSIST OF OUR ENTIRE AGREEMENT,NO ONE HAS ANY ORAL OR OTHER WRITTEN REPRESENTATIONS OR PROMISES NOT INCLUDED IN THIS CONTRACT. I THEREBY ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT. CUSTOMER SIGNATURE PRINTED NAME REQUIRED X X me"IIAJAIR-14 REMIT PAYMENT TO: 4141 HAMILTON SQUARE GROVEPORT, OH 43125 HOURS: MON-FRI 7:30 - 5:00 SAT 8:00 - 12:00 ** MISSING KEY FEE $6. GO PAPERLESS,CONTACT US TODAY! ** PAGE 1 OF 1