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Home My WebLink About196152 03/30/2011 CITY OF CARMEL, INDIANA VENDOR: 365194 Page 1 of 1 ONE CIVIC SQUARE BOUNCE HOUSE GUYS CHECK AMOUNT: $750.00 CARMEL, INDIANA 46032 1i7z RIVER RIDGE BROWNSBURG IN 46123 CHECK NUMBER: 196152 CHECK DATE: 3/30/2011 DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340800 040611E 750.00 ADULT CONTRACTORS Carmel ir. Clay Parks &Recreation CHECK REQUEST Date: D 67, L L1 MA R 0 9 2011 Check a abl BY: Name: R6,o c� IJbUS G S Address: r City, State, Zip `16 j Mail check to payee __ZR etum check to requestor Check Amount. 7 5 a Date Required, `"t Check needed for T if To be paid from PO (it applicable) Budget account GL Budget Line Description Supporting documentation or receipt(s) MUST be attached. Requested by (print): 0 y l 1�QC Requested by (signature): Approved by (signature of Division Manager): on this date Form revised 1 -21 -08 2011 -03 -04 15:30 GET MORE JUMP5 LLC 3178529897 3175717926 P ill i�L' 1\ 111JLJ L!<T1��L' 1�liJl\ 1 VT VV VV U rDe%.1P1JU LESSOR Bounce House Guys S N M 1172 River Ridge Dr Brownsburg, IN 46123 317 222 9522 Phone ORGANIZATION NAME 1- 888 -859 -2947 Fax Y ADDRESS 3 E 76 3 'C Crn 1 ZIP V DELIVERY DATE/NHE u P I PHONE NO. V O PICK -UP DATE(rVKE PTIONE NO. Caw w>e oEI. VER EARLY? m[:] No UNIT'S SET UP ON WHAT KIND OF SURFACE r)CK -VP •nom 'WILT. HE THE SAME PAVEMENT/ GRASS 0 INDOOR RENTAL TYPFJUNiITS CHECK TYPE Power outlet within 100 feet YES No Bounce Mouse [I3asketbalf banner []Speed Car banner []Luau banner aoba Car ban []Strawb Short ban ❑Curious George ban {]Neutral co bo []Princess combo [)Sports Combo [)Small Obstacle []Rockwall Obstacle rge Obstacle []Slip-n -Slide 8' Wet/Dry Slide OBungee faun Joust Q Adult Sumo Suits []2 air guys$50 a ser to Pool Golf rao a achine Fun Pack$50 snerator$50 I GENERATOR POWERS TWO UNITS ER UNITS DIRECTIONSICOMMENTS DELIVERY FEE S MENT INFO EQUIPMENT SUB'T'OTAL s NONREFUNDABLE DEPOSIT PAID s TOTAL AMOUNT AMOUNT DUE s ,U Payment is due upon delivery in cash only —No checks useless it is Business, Church, coo =e -Need to have a standard wer on 104 foet HOLD HARMLESS PROVISION- CUSTOMER (HEREINAFTER LESSEE) AGREES TO INDEMNIFY, DISCHARGE AND f IOLI) HARMLESS QET MORE LAMPS, LLG DSA BOUNCE HOUSE GUYS AND OFFICERS, AGENTS, EMPLOYEES, WW AND AFFILIATES (HEREINAFTER, LESSOR) FROM ANY AND ALL CLAIMS, DEMANDS. ACTIONS, SUI O J TS, 4ROCFF.DING COSTS, EXPENSES, D ANU LIABILITIES INCLUDING REASONABLE ATTORNEY'S FEES ARISING BY REASON OF INJURY, DISABILITY OR DEATH TO PERSONS, DAMAGE OF PROPERTY OR THEFT, IN CONNECTION WITH OR RESULTING FROM THE USE OF THE EQUIPMENT INCLUDING BUT NOT LFWTED TO, THE MANUFACTUROR, SELECTION, DELIVERY, POSSESSION, USE OPERATION, OR RETURN OF THE EQUI'PWNT, LESSEE HEREBY RELEASES AND HOLDS HARMLESS LESSOR FROM INJURIES OR DAMAGES INCURRED AS A RESULT OF THE USE OF SAID EQUIPMENT UNLESS LESSOR IS DEEMED BY A COURT OF LAW TO BE NEGLIGENT IN ITS ACTIONS. LESSOR CANNOT UNDER ANY CIRCUMSTANCES BE WELD LIABLE FOR INJURIES AS A RESULT OF ACTS OF GOD, NATURE, OR OTHER CONDITIONS BEYOND ITS CONTROL OR KNOWLEDGE. DUTY TO MirrIGATE- IN THE EVENT OF INJURY, DAMAGE OR LOSS DUE TO LESSOR'S NEGLIGENCE, LESSEE AGREES AND ASSUMES THE DUTY TO MITIGATE ALL COSTS RESULTING FROM SAID INJURY, DAMAGE OR LOSS. DISCLAIMER OF CONSEQUENTIAL DAMAGES BY SIGNING THIS CONTRACT, LESSEE AGREES TO FOREGO SEEKING ANY CONSEQUENTIAL DAMAGES IN THE EVENT OF ANY INJURY, DEATH, DAMAGE, DISABILITY, OR LOSS DUE TO LESSOR'S NEGLIGENCE. DISCLAIMER OF WARRANTIES- LESSOR MAMS NO WARRANTIES EITHER. ER. EXPRESSED OR IMPLIED AS TO THE CONDITION OR PERFORMANCE OF ANY EQUIPMENT AND /OR PROPERTY LEASED BY LESSEE FROM LESSOR BY SIGNING TITS CONTRACT, LESSEE AGREES THAT ANY WARRANTY OF MERCHANTABILITY OF FITNESS OF A PARTICULAR. PURPOSE ARE HEREBY DISCLAMIED BY SIGNING THIS CONTRACT. LESSEE AGREES THAT NO EXPRESS WARRANTY AS TO THE CONDITION OR PERFORMANCE OF ANY EQUIPMENT AND/OR PROPERTY LEASED BY LESSEE IS HEREBY DISCLA AED. NEGLIGENCE OR ABUSE- LESSEE AGREES TO BE RESPONSIBLE FOR ANY LOSS OF OR DAMAGE TO LESSOR'S EQUIPMENT AND /OR PROPERTY AND SHALL REMMURSE LESSOR FOR REPLACEMENT OF ANY EQUIPMENT AND /OR PROPERTY OR REPAIR FOR SAID ITEM. LESSEE IS SOLEY RESPONSIBLE FOR ANY LOSS OR DAMAGE THAT OCCURS FOR ANY REASON WHILE THE EQUIPMENT AND /OR PROPERTY IS IN THE POSSESSION OF LESSEE. I understand that thfa document is intended to be as broad and inclusive as perwftfed, by the laws of the State gflndlana and agree that if arty portlon of this agreement is invalid the remainder will continue in full legal force and e; feet. I am of legal age and am �eely sfgning this agreement. I ac wawledge and certify that I had sufficient opportunity to read the rental policy and rental �,t�eemett and understand its contents and agree to be bound by the terms. LESSEE SIGNATURE DATE RL t� u MAR 0 9 2011 ]BY... ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Bounce House Guys Terms 1172 River Ridge Brownsburg, IN 46123 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 3/4/11 4/6/11 Schools Out Camp WB 4/6/11 750.00 Total 750.00 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 Voucher No. Warrant No. Bounce House Guys Allowed 20 1172 River Ridge Brownsburg, IN 46123 In Sum of 750.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. 4CCT #/TITLE AMOUNT. Board Members Dept 1081 -99 4/6/11 4340800 750.00 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 24 -Mar 2011 Signature 750.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund