179558 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 00350714 Page 1 of 1
ONE CIVIC SQUARE AIRWORX CORP CHECK AMOUNT: $337.31
CARMEL, INDIANA 46032 BOX 7842 RELIABLE PARKWAY
CHICAGO IL 60686 -0078 CHECK NUMBER: 179558
CHECK DATE: 11/24/2009
DEPARTMENT ACCOUNT PO NUMBER I NUMBER AMOUNT DESCRIPTION
1120 4350900 210393 -0001 337.31 OTHER CONT SERVICES
-f
Page 1
construction equipment supply
Remit To
BOX #:7842 RELIABLE PARKWAY
CHICAGO,.:IL 5:0686;: 007:8
501 W. RAYMOND ST.
INDIANAPOLIS, IN 46225
317 471 -1272
Bill To.
CARMEL FIRE DEPT
z clvlc s:QUARE WORK ORDER INVOICE
ATTN RICK MARTIN
CARMEL, I 46032
Da
voice#
N 0393
210001
to 10/21/09
Customer:# 1132.;
Job Loc 1540 W 136TH STREET, CA
Job Site" 540 W 136TH :STREET, CARMEL
Job No 2 CARMEL FIRE DEPT
CARMEL FIRE DEPT
540 W 136TH STREET
P O
P,TTN JIM: DAMS
Re
thorized JIMiDAVTS
CARMEL, IN 46'032
ceived.on 10/08f09
5:90 3426
F1nlshed on 10/21/09
Last c
Me
t:er o
n /cus 1132
Equip Make Model Serial';# Description;
0900019144JLG 25AM 0900019144 CUSTOMER OWNED EQUIP
Work Order Description:
INTERMITANT OUTRIGGER CONNECTION PROBS
LABOR DESCRIPTION:
Troubleshot. Found that 3 outriggers are in need of rebuilding on contact strip
for safety's- order parts from shop. Returned, installed parts for outrigger s
nsors. Tested operations- all ok.
PARTS:
Qty Part Number Description U/M Price Extended
ELECTRICAL SYSTEMS
8 0962288 WASHER EA 1.000 8.00
4 3900193 SCREW EA .850 3.40
A6.2
1 4740434 WASHER (QTY 100) EA .910 .91
A8.3
1 FUEL CHARGE 2 FUEL CHARGE 2 EA 40.000 40.00
A8.3
1 FRT FREIGHT CHARGES (PAR EA 5.000 5.00
A8.3
Section Total: 57.31
CONTINUED...
ATTN:.CUSTOMER IS TO CALL EQUIPMENT OFF RENT AND ACQUIRE A TERMINATI(
Dealer agrees to waive certain damages and loss claims against Customer, which are provided for on the reverse side of this contract, in consideration of the following: A. Customer shall pay a fee
10% of gross rental charges. B. A valid certificate of insurance is provided Dealer prior to the hire of equipment, whereby Dealer is named an additional insured on an insurance policy, covering the ri
of loss by damage, death or otherwise, of the subject equipment, and said insurance being primary coverage as against any other insurance which may be provided by Dealer.
DAMAGE WAIVER DECLINED
I HAVE READ AND I AGREE TO THE CONTRACT TERMS ON THE BACK OF THIS DOCUMENT. THOSE TERMS CONSIST OF OUR ENTIRE AGREEMENT. NO ONE HAS ANY ORAL OR OTHER
WRITTEN REPRESENTATIONS OR PROMISES NOT INCLUDED IN THIS CONTRACT. 1 HEREBY ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT.
CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE
YOU ARE CHARGED FOR THE TIME EQUIPMENT IS IN YOUR POSSESSION, NOT TIME IT IS USED, AND CONDITION OF EQUIPMENT DESCRIBED ABOVE IS IN GOOD WORKING ORDER.
TERMS AND CONDITIONS
Airworx Construction Equipment Supplies LLC hereby rents /sells to the Customer, identified on the reverse page of this contract, the j
personal property described on the reverse page of this contract, subject to all of the terms and conditions on each page of this contract, the
Customer in consideration thereof, acknowledges and agrees as follows.
1. That Renter has this date at this time specified received from Lessor the personal property listed and identified in this contract.
2. That this product(s) is to be used by the Renter at the designated address for the stated period and solely for the purposes for which
said equipment was manufactured and intended and he will not misuse any such equipment.
3. That the product(s) will not be removed from the designated address without the written consent of Lessor, except to return it to
the designated Lessor location.
4. That Renter will pay Lessor the cost of replacement or repair of the rented product(s) if lost, stolen or damaged by any cause
whatsoever.
5. That Lessor may at its own discretion, revert all charges to a daily rate if monthly statements or invoices are not paid on due dates.
6. That Renter will immrl�iediately discontinue use of the pe sonal pro erty hhould it at anytime, follgwing the ex, motion of th'
agreement o an spbse uent a reemen�t, become unsafe or 1 a s ate ordisre air. ppurthennor the Renter wi I immediate s noti
L that le eq ipment is unsafe and in disrepair and untl sucr, tiTe as Lesso &has regamed possession the Renter agrees to taKe
all steps reasonably neces to prevent injuries to any person and a property om the rented equipment or product.
7. The Renter hereby agrees to pay all reasonable collection fees, attorney's fees, court costs or any other expenses incurred by the
Lessor to enforce the terms and conditions of this contract.
8. EMNIFICATION: Lessee assumes liability for and. shall inderr�ni defegd and �old.ha less les or, its age its, employees,
qer ,directors, spcGes ors, and, assigns fro�ii and aQa nst ny and aliabilihes, gbligations, losses,emands, lama es mjunes
ff
�incl s use uein but n t lunrte to, bod ly 1 �u aline s and �eat�l�, claims, pe es, suits, etions, costs, al expe sec, mc
u
at!thoe c e o kin an�na a aTin to or an in out o the. tiQ (includin t not 1 ited to
ar er�efects and whether Qrot di co era�l bylessee oresggr), oeration,'own exshlp, selection; delivery, leasmg,' latent
or retui�1 o eguilure on the part of lessee to pertonn or comply with thconditions o s lease.
Without, limiting the gerlesality of the foregQigg, lessee shall at its own cost ap d e pence, de end ess r agam�iist all claims uits or
proceed ngs commenced by anyone in which lessoqr is amed as a. party for which es r is al g to e l able or respon b� as a
result o or arising Qut of the e i�ii ment or n alle e f� act or cu ission b lessor an essee s a 1 be Idle and res onsi��e or all
costs, ex enses, and 1 a i �ttorne g tees i u n icurrecin the �efen a an seltle� y meet, or o err s on, ereo In the event
9 %asl Ac�os counsel Zic e nd�essee shal�b l l essor and re 1 or forall expenses, a ana attorney's fees
y ha
The indemnities and asspmptions of liabilities and obligations herein provided for shall continue in full force and effect
notwithstanding the expiration or other termination o the lease.
Purpose of this Clause:. It is under ?too and afreed by.the partiet that Te purpose of this clause is to mipletely sift t]�e rit of all
elaims relat}ng tQ or ar�sli out o e ease o the equipment to essee Hereunder. It is the intention o the parties at is c ause be
interpreted broadly and in avor of essor.
9. Damage waiver, or sales tax are not included in our rental rates. They are extra! Should Renter option to take damage waiver please
refer to and sign off on separate page containing the "damage waiver provisions."
10. USAGE CHARGE
8 hours 1 day
Equipment used in excess of 8 hours /I day will be prorated to reflect extra hours.
You will be charged for time out NOT time uused. A week is 5 days. A month is 28 days.
11. FUEL
All equipment requiring fuel are full when they leave the yard. You will be billed on the first invoice, only, for fuel.
12. INSURANCE
Once e uipment leaves our yard, the Renter is responsible for it until it is returned and payment received during normal business
hours. �ur insurance does not cover equipment while in customer's possession.
13. OPERATING INSTRUCTIONS
If you have any questions as to proper and safe operation of Rented Equipment, please ask for further instructions.
14. PROBLEMS
If you experience a problem call our store immediately. A 24 -hour answering service will take your call.
15. REPLACEMENT
Customer will be charged retail cost of any and all equipment or accessories not returned.
16. CLEANING
Equipment is to be returned as clean as when it was rented. A charge of $40.00/hour will be charged for cleanup.