HomeMy WebLinkAbout196152 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
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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