187208 07/07/2010 voided CITY OF CARMEL, INDIANA VENDOR: 00350714 Page 1 of 1
ONE CIVIC SQUARE AIRWORX CORP CHECK AMOUNT: $433.89
4� CARMEL, INDIANA 46032 BOX 7842 RELIABLE PARKWAY
CHICAGO IL 60686 -0078 CHECK NUMBER: 187208
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO N UMBER INVOICE NUMBE AMOUNT DESCRIPTION
1120 4350900 217866 -0001 433.89 OTHER CONT SERVICES
Y" a
Page 1
Construction equipment supply
'Rmkt:To
PO BOX 704.2:
INDIANAPOLIS' IN 46207 7042
501 W. RAYMOND ST.
INDIANAPOLIS, IN 46225
317 -471 -1272
Bi11'..To:
(CARMEL FIRE DEPT WORK ORDER INVOICE
2 CIVIC .:SQUARE.
ATTN' RICK MAR TIN
'CARM.EL, IN 46032 Invb3-ce# 217866 0001
Dade.... 6/`16/10
Cusaomer
Job.Loc: 107:TH AND COLLEGE, CAR':
Job 'S1te 107TH AND COLLEGE C No:.i 1. CARNIEL FIRE >DEPT!
CARM:EL FIRE .DEPT
P O
107TH AND ::.COLLEGE>
Authorized GARY BRANDT
ATTN'• RICK MARTIN
Received on 5/<21/10
CARMEL,N 4&:032 is
818 3400
Finished on l; 6/16/10
Last cor /cus 1132;.
a.
Meter:
Equip Model Serial, Description
1454 WORKFORCE CAT 23 1454 CUSTOMER OWNED EQUIP
Work Order Description:
WON'T RAISE PAST 6 11
LABOR DESCRIPTION:
Took charger out and had it repaired. returned w/ charger and installed it. Tes
ed operations- 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
Outside Labor CHARGER REPAIR 29389 *29810 153.89
LABOR:
Mechanic Hours Work Rate Extended
108 2.00 ELECTRICAL SYSTEMS 80.00 160.00
108 1.00 ELECTRICAL SYSTEMS 80.00 80.00
Total Parts Materials 40.00
CONTINUED...
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 lee
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 personal pro erty ?hould it at anytime, foil wing the execution of this
agreement or any subsequent agreement, become unsafe or in a sate ot�disrepair. Furtherm e or tie Renter will immediately notify
Lessor that the equipment is unsafe and in disrepair and until such time as Lesso has regained possession 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. INDEMNIFICATION: Lessee assumes liability for and, shall indemni defend and hold harmless les or, its agents, employees,
ffi ers, directors succesgors a
nd, as from anu a amst any and al�fiabilities, Qbligatlons, losses, demands, dama es injuries
inc�udm but n 't limited to, ly m�urryy illness and death),elaims pe alties, suits actions, costs, and expenses, me ud ng
attorneys ee of wh isgqever kind and.nafure, i 1 l k to or iri ing out of the use, condtion (including, but not limited to, atent
a d other deTeets an whether or not discoverabl by essee or essgr), operation, ownership, selection, delivery, leasing, or return
of the equipment, regardless of where, how, and y whom operatedd, or any failure on the part of lessee to perform or comply with
the conditions c this lease.
Without limiting the generality of the foregoing, lessee shall at its own cost and e Dense, defend lessor agai�ist all claims, suits or
proceedings commenced by anyone in which lessoqr is named as a.party for which es �r is allved to be liable or responsibly as a
result o or arisen out of the e �ii nent, or n alle edd act or omission by lessor
costs, expenses, an es see s all be fable and resp onsible or all
and attorney's tees mcurre in the efense and/or settlement, Ii�dgment, or other r sQ1 In the event
an such action is cor mencea namm lessor as a party essor may, in its sole discretion elect to �efend said action on its own
beT such counsel of it choice, and essee shall be liable for and reimburse lessor for all costs, expenses, and attorney's fees
incurred by lessor in suc defense.
The indemnities and assumptions of liabilities and obli ations herein provided for shall continue in full force and effect
notwithstanding the expiration or other termination of le lease.
Purpose of this Clause:. It is understood and a reed bythe parties that the purpose of this clause is to completely shift the risk of all
IT re, ting to or arisen out of the lease of the equipment to lessee hereunder. It is the intention of the parties that this cause be
mteiprete broadly and m 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 I 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 eqguipment leaves our yard, the Renter is responsible for it until it is returned and payment received during normal business
hours. Our insurance does 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 $40.00 /hour will be charged for cleanup.
R e s Page 2
1115�� T1117 constrrretion equipment supply
Remit To:
r PO BOX 704:2
INDIANAPOLIS, IN 46207 7042.
501 W. RAYMOND ST.
INDIANAPOLIS, IN 46225
317- 471 -1272
Bi11 To.
CARMEL FIRE DEPT-' WORK ORDER INVOICE
:2;..CIUIC SQUARE
ATN :RICK MARTIN
CARMEL, IN 46032
Invoice# 217866'; 0001
Date:... 6/16/10
Cust'omer'> 1:132.:;:
Job.Loc. 107TH AND COLLEGE, CAR.
Job 107TH,.AND COLLEGE, CARMEL Job ,No..'....:1 .iCARMEL FIRE: DEPT
CARMEL .FIRE DEPT
P
10 7TH AND ;COLLEGE
":Autl?ori:zed•. BRAIvDT
ATTN RICK MARTIN ive .2
Rec
ed.. 5
on i1 10
CARMEL, I.N 45032
Fl
818 3400
L
Wished:: on 6/1!6/10:
ast'con %cus 1132
>:Meter
Equip Make Model Serial:# Description':.
1454 WORKFORCE CAT 23 1454 CUSTOMER OWNED EQUIP
Total Labor 393.89
Total Amount 433.89
ALL WORK ORDER INVOICES.
ARE DUE WITHIN 30 DAYS
OF INVOICE DATE
0
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.
VOUCHER NO, WARRANT NO.
ALLOWED 20
AiffVorx
IN SUM OF
Box 7842 Reliable Parkway
Chicago, IL 60686 -0078
$433.89
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 217866 -0001 43- 509.00 $43189 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
JUL: Z 2010
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 iRev. 1995)
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))
217866 -0001 $433.89
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