HomeMy WebLinkAbout198442 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 365194 Page 1 of 1
t,
ONE CIVIC SQUARE BOUNCE HOUSE GUYS
CARMEL, INDIANA 46032 8206 ROCKVILLE ROAD #152 CHECK AMOUNT: $160.00
INDIANAPOLIS IN 46214
CHECK NUMBER: 198442
CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4340800 6/29 160.00 ADULT CONTRACTORS
Carmel c Clay
Parks &Recreation CHECK REQUEST
Date: 611
RAY 1 1011
Check payable to
Name: C
Address: 2
City, State, Zip
Mail check to payee V Return check to requestor
Check Amount Date Required c
Check needed for t XA n 'T /J 0 C<l r IM C 00 id G�
To be paid from
PO (if applicable) L
Budget account GL
Budget Line Description 4 t5qmw +V
Supporting documentation or receipt(s) MUST be attached.
Requested by (pant):
Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 1 -21 -08
2011 -05 -10 16:26 GET MORE JUMPS LLC 3178529897 3175717926 P 1/1
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LESS
Bounce House Guys L NAME
1172 River Ridge Dr do elt a RS N 5 Vt CAA DW,kat-_
Brownsbwg, N 46123 L
317 -222 -9522 Phone ORGANIZATION NAME �l k—
1.888- 859.2947 Fax ADDRESS
3
CI7Y y1P LILP
DELIVERY DATE/rQHE PHONE NO.
PICK -UP DATF✓rUdE PHONE NO.
CAN WEDELIWREARL YES[] NoEl UNI'T'S SET UP ON VPHAT ICII•ID OF SURFACE
I'ICK -UP TD IE WILL BE THE SAME PAVEMENT GRASS MOOR
RENTAL TYPE/UNITS CHECK TYPE Power outlet within 100 feet YES No
Bounce H ous e basketball banner ❑Speed Car banner ❑Lua;u banner []Robo Car ban QStrawb Short ban
[]Curious George ban ❑Neutral mbo []Princess combo ❑Sports Combo []Small Obstacle []Rockwall Obstacle
Large Obstacle []Sllp -n -Slide �ungee Run []Joust E] Adult Sumo Suits 02 air guys$50
er to Pool -Golf rao a achine MFun Pack$50 enerator$50 I GENERATOR POWERS TWO UNITS
OTHER UNIT'S DIRECTIONS/COMMENTS DELIVERY FLEE S
/PAYMENT INFO EQUIPMENT SUBTOTAL 5
NONREFUNDABLE DEPOSIT PAID -r—
TOTAL, AMOUNT DUE
Payment is due upon delivery in o checks
unless it is Business, Church, o choo k Need to have a standard we ou Within 100 feet
HOLD HARMLESS PROVISION CUSTOMER (HEREINAFTER LESSEE) AGREES TO INDEMNIFY, 'DISCHARGE AND
HOLD HARMLESS GET MORE JUMPS, LLC DBA BOUNCE HOUSE GUYS AND OFFICERS, AGENTS, EMPLOYEES,
.OWNER, AND AFFILIATES (HEREINAFTER, LESSOR) FROM ANY AND ALL CLAIMS, DEMANDS, ACTIONS, SUITS,
?ROCEEDING 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 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 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.
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.
DISCLAIMR 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
LEASED BY LESSEE IS HEREBY DISCLAIMED.
NEGLIGENCE OR ABUSE- LESSEE AGREES TO BE RESPONSIBLE FOR ANY LOSS OF OR DAMAGE TO LESSOR'S
EQUIPMENT AND /OR PROPERTY AND SHALL RER BBUSE LESSOR FOR REPLACEMENT OF ANY EQUIPMENT
AND /OR PROPERTY OR REPAIR FOR SAID ITEM. LESSEE 1S 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 this document is intended to be as broad and inclusive as permitted by the laws of the Slate of Indiana and agree
that ljany portion of this agreement is invalid the remainder will continue in full legal force and effect. 1 am of legal age and am
freely signing this agreement. I acknowledge and eery J& that I had sur lcient opportunity to read the rental polity and rental
agreement and understand its contents and agree to
by the terms
U P k
LESSEE SIGNA'T'URE P.
MAY 1011 aL Z 1- 9 C Q l
S P
L�
By:
i 1
APe► rf 3—I
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.
365194 Bounce House Guys Terms
1172 River Ridge Dr
Brownsburg, IN 46123
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/29/11 6/29 Dunk tank Carmel Middle Sch Vac station
160.00
Total 160.00
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.
365194 Bounce House Guys Allowed 20
1172 River Ridge Dr
Brownsburg, IN 46123
In Sum of
160.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TlTLE AMOUNT Board Members
Dept
1082 -1 6/29 4340800 160.00 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
16 -Jun 2011
Signature
160.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund