189104 08/24/2010 CITY OF CARMEL, INDIANA VENDOR: 00350714 Page 1 of 1
ONE CIVIC SQUARE AIRWORX CORP CHECK AMOUNT: $433.89
CARMEL, INDIANA 46032 PO BOX 7042
INDIANAPOLIS IN 46207 CHECK NUMBER: 189104
CHECK DATE: 8/2412010
DEP ARTMENT AC PO NUMBER INVO NUMBE AMOUNT DESCRIPTION
1120 4350900 217866 -0001 433.89 REIS 187208
CITY OF CARMEL, INDIANA VENDOR: 00350714 Page 1 of 1
ONE CIVIC SQUARE AIRWORX CORP CHECK AMOUNT: $433.89
CARMEL, INDIANA 46032 BOX 7842 RELIABLE PARKWAY
CHICAGO IL 60686 -0078 CHECK NUMBER: 187208
CHECK DATE: 7/7/2010
RTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
1 1220 4350900 217866 -0001 433.89 OTHER COOT SERVICES
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conStructlon equipment supply
Remy t 70
J' PO BOX 7642
IN 4 6207 7042
O1 W. RAYMOND ST.
IANAPO.LIS, IN 4622.5
7
-471 -1272
2 811 :Ta..:
cARME �'zRE DEPT; WORK ORDER INVOICE
2.CIV
A RICK MARTIN
CARMEL, IN 6632
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7855:0001
Cus:omer' 1132
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fob SYte 107.TH AND COLLEGE, CARMEL Job Noc 1 07T CARM D L COLLEGE, CAR
FIRE DEPT
IRE DEPT;
CARMEL
P O
1 "07TH` AND: COLLEGE Authorized. GARY. BR.ANDT
ATTN RICK MARTIN
ARMEL, zN 46032
Finshea! on..., 5 /21 /zo:
C 6/16/10
8.18 3400
;Last. Con %cue,: 1132,
;Mete. x'
E ui Make Mode1. Serial
escri
4 ption"
1454 WORKFORCE CAT 23 1454 CUSTOMER OWNED EQUIP
Work Order Description:
NIT RAISE PAST 611
OR 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
708 1.00 ELECTRICAL SYSTEMS 80.00 80.00
Total Parts Materials 40.00
CONTINUED...
r
Oeake. agrees 10 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
E AGE f grass rental charges. B. A valid cartilicale of insurance is provided Dealer prior to the hire of equipment, whetooy Dealer is named an additional insured on on insurance policy, covering the ri;
°g, by damage, death or otherwise, of the subject equipment, and said insurance being primary eovemge as against any other insurance which may be provided by Dealer. 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 ORAi 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 CHARGEO FOR THE TIME EQUIPMENT IS IN YOUR POSSESSION, NOT TIME IT 15 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
)ersonal property described on the reverse page of this contract, subject to all of the terms and conditions on each page of this contract, the
�us er in consideration thereof, acknowledges and agrees as follows.
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. "['hat Lessor may at its own discretion, revert all charges to a daily rare if monthly statements or invoices are not paid on due dates.
6. That Renter will immediately discontinue use of the personal property shquid it, at any time, follgwing the ex.4'eption ol'th's
greement or any subsequent agreement, become posaie or) p a state of dtsrepatr. Furthermnr ttie Renter wtll immedtate notify
scar that the eq ipment rs unsafe and in disrepair and unfit such ti e as Lesso has regamedyossesston the Rcnler agrees to take
al steps reasonably necessary to prevent injuries to any person and all property rom the rente 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. INPI:MNIFICATION: Lessee assumes liat�ility for and shall indemni defend and hold,hai less les or, its agents, employees,
of i ern, directors, ucces. ors, and, assigns Crom and a amst any apd a Eiabilities, obligations, losses, demands, darna es injuries
of udin but n Limited to, bod ly r 3ury fitness an death elatms, pe allies, surfs, etrons, costs, and expenses, tnc ud ng
adorn vs ees of wh isgqe_or kind an nafu're, eta in r to or arrstng out: of eons ttppn (including, bbut.not luzuted to, �atent
a ci oter de(ects and whether qr ati covera�i �y�essee or lessor), operation, ownership, selcvon, del leasing, or return
o? the equipment, regardless of w etc, l and �y wham rate or any failure on the part o lessee to perform or comply with
the condditio Is off__this lease.
Without limiting the generality of the foregoir� g, lessee shall at its own cost and e. pence, defend ess r agai �ist all claims suits or
proceed ngs commenced by anyone in which lessqr is amed as a, party for which esspr is all g to �je 1 abke or resport bl as a
result of or arisin ut of the eq�i ipment, or n alle c� act or omissio�pi by lessor and lessee stall be 1 able and resFF �e or all
costs, expenses, a attomey's tees.inc rredin theef:ense and /or seltlement, lydginen,t, or other r s 1 In the event
n such action is commenced namitt� lessor as a party lessor may to tts sole discretion elect to e end said action on its own
�eial f wit i ounsel of it c}�oice, an dd essee shall be ]ia61e 1'or and reimburse lessor or ah costs, expenses, and attorney's fees
incurred by Icssor in such 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 lease.
Purpose oqf this Clause'. It is under rood and a reed by.the parties that t ie purpose of this clause is to completely sift the risk of all
claims re
l ring t or ar stn our of the lcase o the equipment to lessee �ereunder. It is the intention of the parties at this clause be
interpreted broadly and in Favor of lessor.
9. Dainage 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
3 hours I 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 Crst invoice, only, for fuel.
12.1NSUKANCE
Office e leave our yard, the Renter is responsible for it until it is returned and payment received during norinal business
liours. (fur insurance does not cover equipment while in customer's possession.
13. op E R..ATING INSTRUCTIONS
Ifyou 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.
iS.RLPLACEMENT
Customer will be charged retail: cost of any and all equipment or accessories not returned.
16, CLEAN IN G
Equipment is to be returned as clean as when it was rented, A charge of 540.00 /hour will be charged for cleanup.
Page 2
construction equlpmanl supply
Rem t To
r RO BOX 7092
s�cpa6*trla
t== INDIANAPOLIS, .IN 4: -7092
W. RAYMOND ST.
IANAPOLIS, IN 46225
7 -471-1272
Brill ;.To
CARMEL! FIRE DEPT WORK ORDER INVOI
2',;CIUIC SQUARE
ATTN ;RICK MARTIN
CARMEL,, IN:'46D32
I
once# 217866 0001'
aCust.omer 1132
Job L oc l 0 7TH AND COliLEGE C
7bb Site
:;107T AND COLLEGE
Job Na CARMEL FhRE DEPT
CARMEI FIRE DEPT
P
O
7TH `AND ;COLLEGE 'Auttzorized GARY''; BRAnDT
MARTIN
ATTN >RICK`: „Received :on
'CARMEN IN; 46032
�'1n.�shed :on 6/16/10
i` 81`8 3400 1132
ssj
Last ;con /cus
:Meter
Equip?;# Make Model Serial Description::
1454 WORKFORCE CAT 23 1454 CUSTOMER OWNED EQUIP
Total Labor 393.8
0 Total Amount 433.89
ALL WORK ORDER INVOICES.
ARE DUE WITHIN 30 DAYS
OF INVOICE DATE
Baler agrees to waive cenain damages and loss claims against Customer, which are provided for on the reverse side Of this contract, in consideration of [he following: A. Customer shall pay a fee
of gross rental charges. B. A valid ceniiicate of insurance is provided Dealer prior to the hire of equipment, whereby Dealer is named an additional insured on an insurance policy, covering the 6
loss by darn,ige, death or otherwise, of the subject equipment, and said insurancC 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
AirWorx
IN SUM OF
807842 Reliable Parkway
Chicago, IL 60686 -0078
$433.89
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
�O# I Dept. INVOICE NO ACCT #ITITLE AMOUNT Board Members
1120 217866 -0001 43- 509.00 $433.89 I 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,, 2 2010
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
rescribed by Slate Board of Accounts City Form No. 201 iRev, 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
m e or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
Thom, 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 $43189
hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
Ath IC 5- 11- 10 -1.6
20
Clerk- Treasurer