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Home My WebLink About196151 03/30/2011 CITY OF CARMEL, INDIANA VENDOR: 365194 Page 1 of 1 0 F, ONE CIVIC SQUARE BOUNCE HOUSE GUYS CHECK AMOUNT: $550.00 CARMEL, INDIANA 46032 1172 RIVER RIDGE BROWNSBURG IN 46123 CHECK NUMBER: 196151 CHECK DATE: 3/30/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340800 040611A 550.00 ADULT CONTRACTORS Carmel ir, Clay Parks Recreatio n CHECK REQUEST i 1 MAR 0 7011 Check a able to Name: BY: bf�+�1eQ. L� S Address: 11 r City, State, Zip 1 x� bbC x Mail check to payee I Retu m check to re uest q or Check Amount S� Date Re uired: 6 Check needed tor ki cx- To be paid from PO (if applicable) Budget account GL LA 6g6D Budget Line Description Supporting documentation or receipt(s) MUST be attached. Requested by (print): (b�? C�CR� _U6 Requested by (signature): Approved by (signature of Division Manager): on this date Form revised 1 -21 -08 2011 -03-04 15:35 GET MORE JUMPS LLC 3178529897 3175717926 P 1/1 JL'_ 1'w 11V YJa. V LL' 1 1172 River Ridge Dr "V Brownsburg, IN 45123 317 -222 -9522 Phone 01WANIZATION NAME 1 859 -2947 Fax 41 ADDRESS MLW Hai n c }ys Cf1ry GU zT P 0_3 2, DELMRX DATEITIML If r/ PHONE NQ, PICK -UP DATEn IME PHONE NO. CAN WE D$LIVEREARLVI m[] No UNTI'S SET UP ON WHAT F SURFACE PICKUP Tn4E WML BE 7WE SAME PAVEMENT GRASS R RENTAL TYPE/UNITS CHECK TYPE Power outlet within 100 feet YES No El Bounce HOIISG QBasketball banner QSpeed Car banner [DLuau banner obo Car ban E]Sbvwb Short ban oGurious George ban combo OPrincess combo [jSports Combo mall Obstacle [W gall Obstacle OLarge Obstacle []Sllp- nSllde ['J1 S' Wet1Dry Slide (Ekungae Run C lour Aduft Sup guys�50 aser tao rIPool-Golf raoke Machine un Pr>ICk$50 enerator$50 -1 WQ UNITS OTHER UNITS DIRECTIONSICOMMENTS DELIVERY FEE— s /PAYMENT INFO EQUIPMENT SU. NONREF UNIDABL TOTAL AMOUNT i Payment is due u, necks unless it is Business, k tic. -Need to have a Stand -r malt V ithin 140 f=1 HOLD HARMLESS PROVISION- CUSTOMER (HEREINAFTER LESSEE) AGREES'. .rvDEMNIFY, DISCHARGE AND FOLD HARMLESS GET MORE JUMPS, W DBA BOUNCE HOUSE GUYS AND OFFICERS, AGENTS, EMPLOYEES, OWNM AND AFFILIATES (IYEREINAFTEI, LESSOR) FROM ANY AND ALL CLAIMS, DEMANDS, ACTIONS, SUITS, PROCEEDING COSTS, EXPENSES, DAMAGES, AND 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 LIMITED TO, THE MANUFACTUROR, SELECTION, DELIVERY, POSSESSION, USE OPERATION, OR RETURN OF THE EQUIPMENT. LESSEE HEREBY RELEASES AND HOLDS HARMLESS LESSOR FROM INIURMS OR DAMAGES INCURRED AS A RESULT OF THE USE OF SAID EQUIPMENT UNLESS LESSOR IS DEEMIED BY A COURT OF LAW TO BE NEGLIGENT IN ITS ACTIONS. LESSOR CANNOT UNDER ANY CIRCUMSTANCES BE HELD LIABLE FOR INJURIES AS A RESULT OF ACTS OF GOD, NATURE, OR OTHER CONDITIONS BEYOND ITS CONTROL OR KNOWLEDGE, DUTY TO MITIGATE- 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. DISCLAUKER 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. DISCLAIInR OF WARRANTIES- LESSOR MAKES NO WARRANTIES EITHER EXPRESSED OR IMPLIED AS TO THE CONDITION OR PERFORMANCE OF ANY EQUIPMENT AND /OR PROPERTY LEASED BY LESSEE FROM LESSOR BY SIGNING THIS CONTRACT, LESSEE AGREES THAT ANY WARRANTY OF MERCHANTABILITY OF FITNESS OF A PARTICULAR PURPOSE ARE HEREBY DISCLAIMED BY SIGNING THIS CONTRACT. LESSEE AGREES THAT NO EXPRESS WARRANTY AS TO THE CONDITION OR PERFORMANCE OF ANY EQUIPMENT AND /OR PROPERTY y LEASED BY LESSEE IS HEREBY DISCLAIMED. NEGLIGENCE OR ABUSE- LESSEE AGREES TO BE RESPONSIBLE FOR ANY TOSS OF OR DAMAGE TO LESSOR'S EQUIPMENT AND /OR PROPERTY AND SHALL REIMBURSE LESSOR FOR REPLACEMENT OF ANY EQUIPMENT 1 AND /OR PROPERTY OR REPAIR FOR SAID I'T'EM. LESSEE IS SOLEY RESPONSIBLE FOR ANY LOSS OR DAMAGE i THAT OCCURS FOR ANY REASON WHILE THE EQUIPMENT AND /OR PROPERTY IS IN THE POSSESSION OF LESSEE. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the Srare,oflndlana and agree that l w' portion of this agreement is invalid the remainder will corWintte in full legal force and effect. I am of legal age and am freely signing this agreement. I nc rrawl and cerro� that I had svfflcierd opportunity to read the rental policy and rental agreement and understand its contents and agree to be bound by the terms, LESSEE SIGNATURE DATE t MAR 0 9 1011 BY........................ ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly of hours, rate per hour td show; k number of units, price per unit, etc where dat service rendered, by whom, rates per day, number Payee Purchase Order No. Terms Bounce House Guys 1172 River Ridge Brownsburg, IN 46123 Invoice Invoice Description PO Amount Date Number (or note attached invoice(s) or bill(s)),X 28283 550.00 314111 4!6!11 Schools Out Camp WC 416111 Total 550.00 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 2a Clerk- Treasurer Voucher No. Warrant No. Bounce House Guys Allowed 20 1172 River Ridge Brownsburg, IN 46123 In Sum of$ 550.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept 1081 -99 416!11 4340800 550.00 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 550.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund