HomeMy WebLinkAbout184152 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 00350714 Page 1 of 1
ONE CIVIC SQUARE AIRWORX CORP
CHECK AMOUNT: $200.00
CARMEL, INDIANA 46032 BOX 7842 RELIABLE PARKWAY
CHICAGO IL 60686 -0078 CHECK NUMBER: 184152
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 215681 -0001 200.00 OTHER CONT SERVICES
Page 1
cnrastructian erlu,prneret s,rpply Renllt TO
P&: .BOX 70:42
INDIANAPOLIS IN 46207. 704:2
501 W. RAYMOND ST.
INDIANAPOLIS, IN 46225
317 471 -1272
B311 <To.>
CARMEL FIRE DEPT
WORK ORDER INVOICE
2 CIVIC SQUARE
ATTN:'RCK MARTIN
CA IN 46032
Invo ce#
2
:Date;. 4 /Ql /10
Cu s tome r'' 1 113 2
job: 1077H AND COLLEGE, CAR':
Jab Site :107TH AND COLLEGE,. CARMEL
Job<?No._.. 1 CARMEL FIRE DEPT
CARMEL FIRE:. DEPT
P O s
„107TH? AIuD: C OhLEGE "Au
th'orized GARY BRANDY
ATTN ;RICK MARTIN Received;: on 3/?3/10
CARMEL, IN 46032
Finished; on 4 01 10<
8'.l 8 3.4 0 0
La
1132
st con /cus,,
Meter
Equip Make Model Serial. Descript� oz�
1454 WORKFORCE CAT 23 1454 CUSTOMER OWNED EQUIP
Work Order Description:
LIFTING ISSUES
LABOR DESCRIPTION:
Troubleshot. Found charger had a bad 20 amp fuse. Replaced fuse. Tested operati
ns- all ok.
PARTS:
Qty Part Number Description U/M Price Extended
ELECTRICAL SYSTEMS
1 FUEL CHARGE 2 FUEL CHARGE 2 EA 40.000 40.00
Section Total: 40.00
LABOR:
Mechanic Hours Work Rate Extended
108 2.00 ELECTRICAL SYSTEMS 80.00 160.00
Total Parts Materials 40.00
Total Labor ALL WORK ORDER INVOICES 160.00
Total Amount ARE DUE WITHIN 30 DAYS 200.00
OF INVOICE DATE
s s a r
Dealer agrees 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: A. Customer shall pay a fee
10% of gross rental charges. B. A valid certificate of insurance is provided Dealer prior to the hire of equipment, whereby Dealer is named an additional insured on an insurance policy, covering the ri
of loss by damage, death or otherwise, of the subject equipment, and said insurance being primary coverage as against any other insurance which may be provided by Dealer.
DAMAGE WAIVER DECLINED
I 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 HEREBY ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT.
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
YOU ARE CHARGED FOR THE TIME EQUIPMENT IS IN YOUR POSSESSION, NOT TIME IT IS USED. AND CONDITION OF EQUIPMENT DESCRIBED ABOVE IS IN GOOD WORKING ORDER.
TERMS AND CONDITIONS
Airworx Construction Equipment Supplies LLC hereby rents /sells to the Customer, identified on the reverse page of this contract, the
personal property described on the reverse page of this contract, subject to all of the terms and conditions on each page of this contract, the
Customer in consideration thereof, acknowledges and agrees as follows.
1. That Renter has this date at this time specified received from Lessor the personal property listed and identified in this contract.
2. That this product(s) is to be used by the Renter at the designated address for the stated period and solely for the purposes for which
said equipment was manufactured and intended and he will not misuse any such equipment.
3. That the product(s) will not be removed from the designated address without the written consent of Lessor, except to return it to
the designated Lessor location.
4. That Renter will pay Lessor the cost of replacement or repair of the rented product(s) if lost, stolen or damaged by any cause
whatsoever.
5. That Lessor may at its own discretion, revert all charges to a daily rate if monthly statements or invoices are not paid on due dates.
6. That Renter will immediately discontinue use of the poXsongl property phould it at any time, foll
oing the exec
wution of this
agreement or any subsequent agreement, become unsa e or 1 a s ate o disrepair. Furthermor e Renter y✓ill immediately notify
L ssor that the eq ipment is unsafe and in disrepair and untifsuch time as Lesso has regainedpossession the Renter agrees to take
all steps reasonably necessary to prevent injuries to any person and all property rom the rented equipment or product.
7. The Renter hereby agrees to pay all reasonable collection fees, attorney's fees, court costs or any other expenses incurred by the
Lessor to enforce the terms and conditions of this contract.
8. IN��jjEMNIFICATION: Lessee assumes lia ility for and, shall indemni defend and hold harmless les or, its agents, employees,
offi�ers, directors, successors, an as$igns from and namst any and alVfiabilities, obligations, losses, demands, damags injuries
(mc uding but npt limited to, bo ily mIury death), claims, pe altres, suits, actions, costs, and expenses, me udmg
attorn ys Tee of whatsoever kind ana natur illness an e, relapin to or arising out of the.use, condo n (including, but not limited to, latent
and otVier det and whether pr igot discoverabl by essee or lessor), operation, ownership, selection, delivery, leasing, or return
of the equipment, regardless o w ere, how, and y whom operated, or any failure on the part of lessee to perform or comply with
the conditions o this lease.
Without limiting the generality of the foregoing, lessee shall at its own cost and expense, defend lessor against all claims suits or
proceed ngs commenced by anyone in which less p is named as a, pgrty for which less r is all g d to be liable or responsible s a
result of or arising out of the equipment, orpny al�eseP act or omission by lessor and lessee s a�l be liable and resvonsible for all
costs, expenses and attorney' incurre in the e ense and /or settlement, judgment, or of er res?lutionthereo In the event
b n such action is commenced namin lessor as party lessor m y in its sole discretion elect to eend said action on its own
ehialf with ounsel of its choice, and lessee shal�6e liable for an� reimburse lessor for all costs, expenses, and attorney's fees
incurred by Yessor in such defense.
The indemnities and assumptions of liabilities and obligations herein provided for shall continue in full force and effect
notwithstanding the expiration or other termination o lease.
Purpose of this Clause: It is understood and a reed by the parties that the purpose of this clause is to o pletely s ift the risk of all
claims relgting to or arisin out of the lease ofthe equipment to lessee hereunder. It is the intention o t i e parties t at this clause be
mterprete broadly and in avor of lessor.
9. Damage waiver, or sales tax are not included in our rental rates. They are extra! Should Renter option to take damage waiver please
refer to and sign off on separate page containing the "damage waiver provisions."
10. USAGE CHARGE
8 hours 1 day
Equipment used in excess of 8 hours /1 day will be prorated to reflect extra hours.
You will be charged for time out NOT time uused. A week is 5 days. A month is 28 days.
11. FUEL
All equipment requiring fuel are full when they leave the yard. You will be billed on the first invoice, only, for fuel.
12. INSURANCE
Once e8uipment leave- s,our,yard,-the Renter is responsible for it until it is returned and payment received during normal business
hours.' insurance oes not cover equipment while in customer's possession.
13. OPERATING INSTRUCTIONS
If you have any questions as to proper and safe operation of Rented Equipment, please ask for further instructions.
14. PROBLEMS
If you experience a problem call our store immediately. A 24 -hour answering service will take your call.
15. REPLACEMENT
Customer will be charged retail cost of any and all equipment or accessories not returned.
16. CLEANING
Equipment is to be returned as clean as when it was rented. A charge of S40.00 /hour will be charged for cleanup.
%FA- 'Y"�"` ..rr u ♦C J ti, e ...r m-.. ..A a --i L_ri- ".er..�4-a ^v -'r-"" r •'r. r-,, t�+�= '�D`' 7:- ..n1r..1 u
WORK REPAIR ORDER WORK ORDER NO.
TECH. SIGNATURE IdT�
DATE TIME IN TIME OUT TECH
Customer Owned Shop
cods7rucfian egnipma6f supply fl' Customer Owned Field
Planned Maitenance
Indianapolis Cincinnati Warsaw Fleet Maintenance
317.471 -1273 553.467 -9982 574. 268 -9664
AME JOB SITE ADDRESS
Mml ll
BILLING ADDRESS CITY,' P.O. NO.
CITY PHONE JOB SITE CONTACT PHONE
6A y g/fl Y8 o
WARR. REPAIR NO. MAKE y^ MODEL PERSON CALLING PHONE
�APr K pnfCs CAT
FLEET NO. SERIAL NO. EQUIP. HR: METER TIRE SIZE
ENGINE MODEL NO. ENGINE SERIAL NO.
NATURE OF TROUBLE
QTY RPM PARTS NO. PARTS DESCRIPTION AMOUNT DESCRIPTION OF WORK BY TASK
LABOR CODE f
SS
CUSTOMER REPAIR ONLY PICK -UP &r DELIVER
TERMS AND CONDITIDNS Y TOTAL PARTS
DISCLAIMER OF WARRANTIES; WAIVER OF.DAMANGES,: LIABILIX_ FO R DAMAGE TO
PERSONS AND PROPERTY:
airWDrx makes no warranties, expressed or implied, as to the equipments andfor repair's TOTAL LABOR HR
merchantability for any particular purpose. Customers sole remedy for any failure of or defeat
In the equipment shall be limited to the value charged for7epair, parts, and equipment. MILEAGE
airJJorx shall non be responsible for any loss, damage, or injury to customer's property
including incidental, special, or consequential damages in any way connected with the
operations of, use of, defect in, or failure of equipment. Customer shall indemnify and hold FREIGHT SHIPPIN
airWorx harmless from any claims of third parties for loss, injury, and damage to their persons
and property arising out of customer posession, use maintenance or return of equipment, SALES TAX
including legal costs incurred in defense of such claims. Customer shall furnish airWorx with .r
a complete report involving equipment, parts, and or repair including names and addresses of
all persons involved and all witnesses. TOTAL
airWorx is not responsible for goods left 30 days, not for loss by fire or theft.
I hereby authorize airWorx to perform the necessary services and grant permission to airWorx My signature below constitutes acceptance of above work as being satisfactory and
to operate equipment described above and to repair if necessary I further understand that that equipment has been left in good condition.
any estimated charges charges fluctuate 10%
Customer MECHANIC Customer
PLEASE PRINT PLEASE PRINT
Customer DATE END DATE Customer DATE f
SIGNATURE J SI fth� RE
VOUCHER NO. WARRANT NO.
ALLOWED 20
AirWorx
IN SUM OF
-7o qZ
Box �42- Reliable Parkway
Ckiicae, I e -0078 1/+4
$200.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO Dept, INVOICE NO. ACCT #MTLE AMOUNT Board Members
1120 215681 -0001 43- 509.00 $200.00 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
APR 1 2 2 010
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1 ,995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
215681 -0001 $200.00
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