HomeMy WebLinkAbout198920 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: $350.00
INDIANAPOLIS IN 46214
�o CHECK NUMBER: 198920
CHECK DATE: 7/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4340800 7/22 350.00 ADULT CONTRACTORS
Carrel c Clay
Parks &Recreation CHECK REQUEST
Date:
Check Payable to
Name: C S
Address: 02 bb 1�tl�'��
City, State, Zip
Mail check to payee Return check to requestor
I
Check Amount SS Dr Date Required 712-2-A
r
Check needed for
To be paid from
PO (if applicable)
Budget account GL �q0 r U �1
Budget Line Description V
Supporting documentation or receipt(s) MUST be attached.
Requested by (print): V 2 P�
Requested by (signature):
Approved by (signature of Division Manager):
on this date
r I i Form revised 1 -21 -08
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2011-05 -10 m:n GET MORE JUMP5 uc 3178529897 3175717926 p m
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Bounce House GUYS
8206 Rockville Rd 4152 LENSEE/ORG NAME PI
317-222-9522 Phone
DEJAVERY FEE'
.07% SALE TAX PAID
PAID IN FULL OR AMOUNTIWE 34 UNITS SFT UP ON WHAT KIND OF SURFACE
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Payment is due upon delivery h) C N PAVEMENTE] GRASS a INDOOR
urflv�s it is Business, Church, Schoolcheck Power outlet witbin 104) feet YES No F1 Public Location YES
OTHER OTHER
F Bounce House_ [:IWKEND Bounce House LjNeutral Combo_[:) B-BALL ban [:]Luau banEjRcbo Car ban
Curious George ban E]Strawb Short ban Kahuna Slide [:]Small ObstacleE]Large Obstacle DTurbo Rush
Wrecking Ball [DBungee Run DJoust 0 ult Sumo Suits
.]Cash Machine E]Shoot and ThFOW game
jFast pitch
F�D~c~ pond 0'^g^ St 0'—n P--E3---n—A—'---- []Dunk Tank f l Generator 0Snow Cone MCotton Candy
HOLD HARMLESS PROVISION- CUSTOM CA(HCRC|NAFTORLBSSK6) A6kU'13S?0 INDEMNIFY, DISCHARGE ANDHOLD
HARM i.F5SGRTM0o6N MPS, LLCD88 BOUNCE UOUSFQ|YS AND OPF|CE AGENTS, EMP|/)YR8S. OWN ER, AND
AFF(L|ATFS(HpNF|N8FT8P. LESSOR) FROM ANY AND ALL CLAIMS, DEMANDS, ACTIONS, SUITS, PROCEEDING COSTS,
EXPENSES, D»MACCS. AND LIABILITIES INCLUDING REASONABLE ATTORNEY'S P2BS ARISING RY REASON OPINJURY,
DISABILITY OR DEATHTO PERSONS, DAMACE OF PROPERTY OR THEFT, IN CONNECTION WITH OR RESULTING FROM THE
USE OR SET UPUPT|(K|�QU|PMCN?|M[U1NNGgUTNOTUM[[| TO, THE MANUFAC7URUR,SBLBC?|0N'U�L|vLAY.
POSSESSION, USE OPERATION, OR RETURN OF THE EQ1,11PMENT, LESSEL JJERERY RELEASES AND HOLDS IIARMLLSS
LESSOR FROM |N0V(gS0R DAMAGES INCURRED ASARC5mJ0P THE USE 01' SAID EQUIPMENT UNLESS LESSOR |3
DEFMFD RYA COURT OF LAW TO BE NEGLIGENTIN J'FS ACTIONS. LLSSOK CANNOT UNDER ANY CIRCUMSTANCES BE HELD
LIABLE FOR INJURIES AS A RFSIJI.T OF ACTS OF GOD, NATUPE. OR OTHER CONDITIONS BEYOND ITS CONTROL OR
KN0YVL8U[L.
DUTY TO MITIGATE- INTHELvENTOF INJUIZY, DAMAGE OR LOSS DUE TO LFSSOR'S NEGLIGENCE, LESSEE ACkSC5AND
A8SUME.S7HBDU7y'[U MITIGATE ALL COSTS ACSD|.7|NG FROM SAIL) INJURY, DAMAGE ORLOSS.
DISCLAIMER OF CONSEQUENTIAL DAMAGES- RYS|�N\N0THIS CONTRACT, LESSEE AGREES TO FOREGO SEEKING ANY
C0NSrQUEN7|N. DAMAGES |N THE EVENT UF ANY |N/VRY. DEATH, D8M8GE'.UI3ABD17Y.OR LOSS DUE TOLESSOR'S
NKGL|G, L"NCE.
DISCLAIMER OF WARRANT/BS' LESSOR MAKES NO WARRANTIES 87HEK EXPRESSED OR IMPLIED AS?0 THE CONDITION
OR PERFORMANCE 0PANY EQO|PM6NT*mU/OK PROPERTY |.KaSED BY LESSEE FROM L833OFL BYS|CM|NCll|B
CONTRACT |.F5SpRACRBOS THAT ANY VYARR8N 0F MCK[HxN7AB|UTY01 FITNESS OF PARTICULAR PURPOSE ARE
HSKU8Y DISCLAIMED BY SIGNING THIS CONTRACT. LUSSLEAGREFS THAT NO OXPN[SSW&KKANTy ASTO THE CONDITION
OR PERI"ORMANCE 01 ANY EQUIPMENT AND/OR PROPEHTY 1,FASFD BY LESSEE IS HEREBY DISCI,AIMED.
NEGLIGENCE OR8BU5[- LESSEE AGREES TO RR VRSPONS|8LL' FOKANY |I$S OF OR DAMAGE TO LESSOR'S EQUIPMENT
AND/OR PROPERTY AND SHALL REIMBURSE LESSOR FOR REPLACEMENTOV ANY EQUIPMENT AND/Olk PROPERTY. LESSEE
IS SOLCY RESPONSIRLF FOR ANY LOSS OR DAMAULTHAT OCCIIRS FOR ANY REASON WHILE THE EQIjIPMENT AND/OR
PROPERTY IS INTHE POSSESSION OF LESSFE AND/OR UNTIL!NSPECTION DATE, INSPECTIONS- LESSEE AGRFFS TO
A1,10W LESSOR ONE WEEK FROM PICK-UP DATE TO INSPFCTEQUIPMENT AND/OR PROPERTY FOR DAMAGES CAUSED BY
LFAS8F.|PLESSOR FINDS ANY DAMAGGS, LESSEE WILL RS P|M6MC|&LLY RGSPON3IB|.8 FOR DAMAGES.
Lhat Lhis document is interided to be as broad arid inclusive o.v per-riticted b.V the laws of the State ofIndiana and agree that Ifmy portion ,/m*
v»r,=°"t is invalid, moremuinu", will con tin tie /v full legal force arid ef)act. /"m«//c»v/ age arid a freely si this ^L/vcx'mwleug, and cvrtift
that Iliad "wyic/ent"nv",m"a//" read m, rental »^/ky and rental oqna=""/ and understand its con x=tS and a 'ohe bound kv the /,xm,
F" 1 R|GNATUKD DATE
Silly string is strictly prohibited at your party and/or near units- You will be respqnsible for replacement cost of
unit If any silly string gets on it. We do not rent to any customer who has silly string at their event. NO SILLY
UNIT IF WIND SPEel)-EXCEIEDS 16 MPH ANDIOR RAININQ, YOU ARE FULLY LIA13LE/ RESPONSIBLE FOR ALL
ftt4TED ITEMS/UNIT(S) UNTIL PICKUP AND/OR ANY DAMAGES CAUSED WHILE IN YOUR POSSESSION UNTIL
IN$PECTION DATE. A $50= cleaning fee wlll.-be charged if the unit agirem
time or on th ection date Is
escriptio
excessively dirty, or trash-left iheide the unii.
�k: J 2,
Budget
Lim) Descr
Purchaser
Approval Date
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
8206 Rockville Rd 152
Indianapolis, IN 46214
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/4/11 7/22 Program Clay Middle School 7/22/11 28544 350.00
Total 350.00
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
8206 Rockville Rd 152
Indianapolis, IN 46214
In Sum of
350.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -1 7/22 4340800 350.00 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
350.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund