HomeMy WebLinkAbout196151 03/30/2011 CITY OF CARMEL, INDIANA VENDOR: 365194 Page 1 of 1
0 F, ONE CIVIC SQUARE BOUNCE HOUSE GUYS CHECK AMOUNT: $550.00
CARMEL, INDIANA 46032 1172 RIVER RIDGE
BROWNSBURG IN 46123
CHECK NUMBER: 196151
CHECK DATE: 3/30/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340800 040611A 550.00 ADULT CONTRACTORS
Carmel ir, Clay
Parks Recreatio n CHECK REQUEST
i
1 MAR 0 7011
Check a able to
Name:
BY:
bf�+�1eQ. L� S
Address: 11 r
City, State, Zip 1 x� bbC x
Mail check to payee I Retu m check to re uest
q or
Check Amount S� Date Re uired: 6
Check needed tor
ki cx-
To be paid from
PO (if applicable)
Budget account GL LA 6g6D
Budget Line Description
Supporting documentation or receipt(s) MUST be attached.
Requested by (print): (b�? C�CR�
_U6 Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 1 -21 -08
2011 -03-04 15:35 GET MORE JUMPS LLC 3178529897 3175717926 P 1/1
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1172 River Ridge Dr "V
Brownsburg, IN 45123
317 -222 -9522 Phone 01WANIZATION NAME
1 859 -2947 Fax 41 ADDRESS
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DELMRX DATEITIML If r/ PHONE NQ,
PICK -UP DATEn IME PHONE NO.
CAN WE D$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