HomeMy WebLinkAbout198919 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 365194 Page 1 of 1
ONE CIVIC SQUARE BOUNCE HOUSE GUYS
CARMEL, INDIANA 46032 8206 ROCKVILLE ROAD #152 CHECK AMOUNT: $160.00
INDIANAPOLIS IN 46214 CHECK NUMBER: 198919
CHECK DATE: 716/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4340800 7/20 160.00 ADULT CONTRACTORS
Carmel c. Clay
Parks &Recreation CHECK REQUEST
Date: a/ �2
Check payable to
Name: v
Address:
City, State, Zip ✓l�uc�ts� 2 �`1
Mail check to payee y Return check to requestor
Check Amount Date Required
Check needed for y) K
To be paid from
PO (if applicable) S
Budget account GL `"I 3 I 0
Budget Line Description 1M t
V
Supporting documentation or receipt(s) MUST be attached.
Requested by (print): JIVI Can (a Y)
Requested by (signature):
Approved by (signature of Division Manager):
on this date 5 13A
Form revised 1 -21 -08
2011-05 -10 16:21 GET MORE JUMP5 uc 317852980 3175�17926 P m
1A"1XVd1 r,111 I VV VV U L U ux
8206 Rockville Rd #152 LESSEE/ORG 0edw
DELIVERY FEE
Payment is due upon deliyery i 011 z 11 loh�eks PAVEMENT[:) GRASS INDOOR E]
Public Location V
unless it is Business, Church, o Clio( C Powcroutlel wi(hin 100 Net YESR No[
OTHER S
F_� Bounce House_L��KEND Bounce House LjNeutral Combo—L_j B-BALL ban []Luau ban [:]Robo Car ban
E]Curious George ban f Short ban oKahuna SlideE]Small ObstacleE]Large Obstacle EjTurbo Rush
CjWre�cking Ball []Bungee Run E]Joust E] Adult Sumo Suits F�Cash Machine []Shoot and Throw game [jFast pitch
[]Duck pond 01-ligh Striker F_jFun Pack EjAirborne AdventurW Dunk Tank [:]Generator Cone E]Cotton Candy
HOLD HARMLESS PROVISION- CI.JSTOMFR (HF.Rf 1 XI) A61IFFS TO INDEMNIFY, DISCHARGE AND HOLD
HARMLESS GFT MORE JUMPS, I.LC DRA BOUNCF. HO(ISI; GUYS AND OFFICERS, AG.F.NT.S, EMPLOYEES, OWNER, AND
APP|WATF,S(HFRE|NAF7EP, LESSOR) FROM ANY AND A|.iOJ\|M.�. DEMANDS, ACTIONS, SUITS, PRUCCLD|NCCUST3.
EXPENSES, DAMAGES, AND L|A8|L|T|L'S INCLUDING K|:0S0NAHL/;ATT0AmI:Y'S�LL-.*S ARISING BYKEaSVNDPINJURY,
DISABILITY OKD[AlUT0 PERSONS, DAMAGE 0P PROPERTY 0Kll{U WITH 0R RESULTING FROM THE
USE UR SET Up0p THE EQUIPMENT INCLUDING BUT NOTL|M|TED TO, THE NANUR\C7UKUV. SELECTION, VFUVF�kY.
POSSESSION, USE OPERATION, OR RETURN OFTHE 1- LESSEE HRRFRY RPLEASES AND HOI.f,),S HARMLLSS
I,ESSOR FROM INJURIES OR DAMAGES INCURRED AS A RESULT 01: THI; USL 01: SAIL) EQUIPMENT UNLESS LESSOR IS
DEEMED BY A COURT OF LAW TO BE NFGI,IGFNT IN ITS ACTIONS, LESSOR CANNOT [.)NDFR ANY CIRCUMSTANCLS BE IILLD
LIABLE FOR INJURIES A1AKESUL?0|'A[lS0P(Q|), MATVKl:.VK OTHER CONDITIONS |3[YOND ]TS CONTROL. OR
KNOWLEDGE,
DUTY TU MITIGATE- |N THE EVENT 0F|NNKY,DAMAGFOR LOSS DUE T0iF3S0K'S NEG LG5SFRAGPCFSAND
ASSUMES THE DUTY T0M|7|CYA7RNJ.COSTS RFSU|J|NC FROM SAID INJURY, DAMA'I0KLOSS.
DISCLAIMER OP CONSEQUENTIAL DAMAGES- UYS|Cm|mC'D{|SCUNTKXC'[��SSCCACKLE'STO�OKEX;U SEEKING ANY
CONS ROUENT|ALDAMAC[S|N7HCRVEN70F ANY |N]o»Y LOSS DUC1l)LESSOR'S
NEGLIGENCE.
DISCLAIMER OF WARRANTIES- LESSOR MAKES No WARRANTIE'S EITHER EXPRESSED OR IMPLIED AS TO THE CONDITION
OR PERFORMANCE OF ANY EQUIPMENT ANID/OR PROPERTY LFASFD BY LES.SFE F LESSOR. BY SIGNING THIS
CONTRACT, LESSEE AGREES THA'r ANY WARRANTY 01: MI'1-'RCIiAN'FARII,ITY 01' J.'ITNFSS OF A PARTICULAR PURPOSE ARE
HEREBY 0SCLA|MCoUYS|CN|H6T|||s CONTRACT. LIESSE68GKELST||Al'N0 EXPRESS WARRANTY aST0 THE CONDITION
OK PERFORMANCE 0P ANY [0U|PMENTAMD/UK|`KUPHR[Y LEASED 8YLESSFE|S HERESY DISCLAIMED.
NEGLIGENCE OR ABUSE- LESSEE AGRFES TO BF RESPONSIBLE FOR ANY LOSS OF OR DAMAGE TO LESSOR'S FQI,IIPMFNT
AND/0RPR0PER7YANDSHALLRE|M8URSCLCSS0RF8K(lCp|^«CFMFN70FANYCQU|yMEN7AND/ORPRUP2K'[Y.LDSSEC
lS3OLEy RESPONSIBLE F0R ANY LOSS ORn8M8CFTHAT0[CUKS FOR ANY KE WHILE 1'HC EQUIPMENT AND/OR
PROP ERTY S INTHE POSSESSION OF LESSFIF AND/Oil UNTIL INSPECTION |6?B INSPECT LESSEE AGMEES To
ALLOW LESSOR ONE WEEK FROM PICK-UP [)ATETO INSPECT EQUIPMFNT AND/011 PROPFRTY FOR DAM� 'CES m'
LEASEE. IF LESSOR FINDS ANY DAMAGES, LESSEE WILL BF FINANCIALLY RESPONSIBLE FOR DAMAGE 4
ngreemenc i.v involid, the remainder will continue in Pill legalffirce Und Cfj�ct. /ain ol Ipgal age and (inifteelyfigning thisagreeinvit. I ackilow[0 C((A1LTPti& y
that I had.vuffit_int n rear] the reninflinficy ai)d renral agreement arid understand its ronten" andr�qrry in he hound by ter'ns.
Silly 5,tring i5, iptly prohibited at your partV andfor near units- You will be responsible for replacement cost
unit If any silly string gets on It. We do not rent to any customer who has silly string at their event. NO SILLY
STRING-CANDY-SHOES-GUM-FOOD-DRINK-CONFETTI—BALLOONS-TAPE INION UNITS, DO NOT USE
UNIT IF WIND SPEED EXCEEDS 15 MPH ANID/OR RAINING. YOU ARE FULLY LIABLE/ RESPONSIBLE FOR ALL
RENTED ITF_MSIUNIT(S) UNTIL PICKLJP AND/OR ANY DAMAGE$- QAL)SIEP WHILP, IN YOUR POSSESSION UNTIL
INSPECTION DATE, A S50.00 cleaning fee will be charged if the unit at picillkiCOOMe or on the Inspection dAte is
excessively dirty, or trash left innide the unit. Description
Bud et
Approval j
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
5/4111 7/20 Program Clay Middle School 7/20/11 28544 160.00
Total 160.00
1 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
Brownsburg, IN -46123
In Sum of
160.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -01 7/20 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
28 -Jun 2011
Signature
160.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund