179586 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 363613 Page 1 of 1
ONE CIVIC SQUARE BOB'S CO2 CHECK AMOUNT: $40.00
�o CARMEL, INDIANA 46032 1750 W HUNTSVILLE ROAD
PENDLETON IN 46064 CHECK NUMBER: 179586
CHECK DATE: 11/24/2009
DEPARTMENT ACCOUNT PO NU MBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 0700 40.00 FOOD BEVERAGES
5
bob C 2 L.L.C. DELIVERY TICKET No. 0`700
"I've Got Gas"
1750 W. Huntsville Road
Pendleton, IN 46064 Date: 0
317-989-9262 765-778-8463
LA (0 S
T ID Oty. Unit Description Hazard Class Item Cylinders •vokne• Unit. Extended Amount
Ship Ship Return Weight Amount 44 V 00
2
3
4
6
7
8
9
SUB TOTAL
IMPORTANT
PLEASE READ CAREFULLY THE TERMS AND CONDITIONS OF SALE WHICH APPEAR ON THE F14EIGHT,
REVERSE SIDE OF THIS DOCUMENT. ALL SALES ARE SUBJECT TO SUCH TERMS AND SALES T AX
CONDITIONS. CUSTOMER SIGNATURE HEREON VERIFIES SHIPPED AND RETURNED RENTAL
CYLINDER COUNT. TOTAL M -0t
TERMS A MONS: THE CU5jOMER HEREIN CONSENTS TO AND ACCEPTS THE ABOVE PRODUCTS SUBJECT TO ALL OF THE CONDITIONS ASSET
"D'CON4
FORTH REVER! SIDE HEREOF P THE EXISTING CONTRACT BETWEEN BOTH PARTIES.
he, By( g lure)
X Date `l Qq
Shipped By
WHITE COPY-OFFICE YELLOW COPY-CUSTOMER
Terms and Conditions
These terns and conditions represent the entire agreement between the parties hereto and there are no collateral, oral or other agreements or
understands, unless expressly stipulated on this invoice.
Warranties Disclaimer
Seller warrants all cylinders, equipment or merchandise delivered herewith will meet the manufacture's standard specifications for the same of
such other specification as may be expressly agreed upon in writing including any written warranty packaged with the item delivered. Sell
further warrants that each item delivered will contornt to (fie promises and affirmations of fact made on the container and label of the item by the
manufacturer. Seller makes no other warranty of any kind whatsoever, express of implied and all implied warranties of merchantability and
fitness for a particular purpose are hereby disclaimed by Seller and excluded from this transaction.
Liability:
Customer understands and agrees that title to the equipment remains in the Seller, except in the case of a sale of merchandise or equipment. until
such time as invoices rendered covering said merchandise or equipment are paid in full. Customer assumes all liability for damages from
accident caused by or incurred in the use or transportations of said cylinders and /or equipment. Customer agrees to indemnify and hold harmless
the said Seller, its officers, agents, and employees from any and all damages and/or liability to any person whomsoever arising out of or resulting
from the use. storage, or transportation of said cylinders and /or equipment by the Customer of anyone else while the equipment is in the custody
of the Customer. The Customer acknowledges receipt of the cylinders and /or equipment in good working condition and repair and agrees to
return it in as good condition subject to reasonable wear and tear, and Customer shall be liable for all damage to or loss of the cylinders and/or
equipment regardless of cause until it shall have been returned to, and receipted for; by the Seller. in the event of any accident involving said
cylinders and/or equipment. Customer shall promptly furnish to Seller a complete report in writing, with names and addresses of witnesses and
parties involved and Customer shall make all reports required by law.
tiSE RESTRICTIONS
None of the above cylinders and /or equipment shall be sublet or loaned by the Customer, nor shall it be removed from the location of the job for
which it was intended to he used as above set forth, nor shall it be removed from the county in which it was delivered to the Customer. except by
prior written consent of the Seller. If the law requires the user to be licensed, the Customer shall not use nor permit use without such license. In
the event of damage, breakage, or mechanical failure of said cylinders and/or equipment for any cause, Customer, at his own expense, shall
forthwith return the cylinders and /or equipment to Seller. Customer is not authorized, without prior written consent of Seller, To expend any
money or Hour any expense for Sellers or Customer's account. for repairs to said cylinders and /or equipment, or for the refilling of said
cylinders. Customer shall not make nor permit to be made any changes in said cylinders and /or equipment. SELLER may terminate this hiring at
any time by tender to Customer of unused rent, in which event Customer shall forthwith return cylinders and /or equipment to the Seller at such
place, within the County, as the Seller shall designate. Customer shall at his own expense, maintain liability and fire insurance and such other
insurance as Seller may request at the time of hiring. In the event of the insolvency or bankruptcy of the Customer, or in the event the Customer
violates any of the terms hereof, or tiles to return the cylinders and/or equipment. or in the event the cylinders and /or equipment is levied upon by
any legal process, this hiring shall. without notice, immediately terminate and all right of the Customer to possession of the cylinders and/or
equipment shall immediately terminate. Setter may retake the same or any part thereof with or without notice and with or without legal process,
and Seller and its agents arc herby authorized to go upon Customer's property and may remove impediments and may use all force necessary to
retake said cylinders and /or equipment, and Customer hereby, for itself and its employees, expressly waives all damages and claims of damage or
trepass. physical or pecuniary. caused by the Seller in the process of taking and removing said cylinders and /or equipment. In the event of any
breach by the Customer hereunder, said Customer promises and agrees to pay all expenses of enforcement hereof and the costs of retaking said
cylinders and /or equipment and the Seller shall be entitled to judgement for such expenses and for all rentals, merchandise, and damages due
hereunder, and for reasonable attorney's fees and court costs.
NOTICE OF NON- WAIVER
The failure by the Seller, at any one or more time, to insist upon the strict performance by the Customer of the covenants, conditions and /or terms
of this agreement, shall not be construed as a waiver of Seller's right to demand strict compliance with and performance of all covenants.
conditions and/or terms hereof. Notice of demand for strict compliance is hereby waived by the Customer, and time is expressly made of the
essence of this agreement.
RETURNED MERCHANDISE
Original invoice must accompany merchandise returned for credit.
RESTOCKING:
Restocking handling charges will be made on regularly inventoried merchandise returned. Special order items are not subject to return for
credit.
LOANED OR RENTED CYLINDERS AND Il'EMS:
By accepting: Loaned cylinders or loaned or rented items, Buyer agrees: To return loaned cylinders to seller on demand: To be responsible for
any loss of, or damage to loaned cylinders and to reimburse Seller at the current rate of charges for such loss or damage: To indemnity Seller
against all loss arising out of irijuries to persons or damage to property connected with the use of the loaned, or rented items specified here, the
loaned cylinders, or the contents of the cylinders: to reimburse Seller for any reasonable costs and /or attorney's fees incurred by Seller in
collecting payment or enforcing the terms of these conditions: to be responsible for loaned or rented items as to proper care. maintenance, loss or
damage of them (normal wear excepted) until such items are returned to Seller.
CUSTOMER'S REPRESENTATION OF SOLVENCY:
Buyer represents to Seller that Buyer has not ceased to pay his debts in the ordinary course of business, that he can pay his debts as they become.
due, and that he is solvent within the meaning of the federal bankruptcy act.
CLAIMS:
All claims for defective material, shortages and discrepancies are waived unless made in writing immediately after receipt of shipment.
Any and all contracts between the parties existing at the date of the execution of this Agreement shall be deemed terminated and cancelled as of
such date, except for the settlement ofsuch rights which may have accrued there under, or may hereafter accrue there under with respect to
unreturned cylinders, containers or other property. This Agreement shalt be finding upon and inure to the benefit of the successors and assigns of
the parties hereto.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or 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.
r l uo4 Terms
J Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
/l lv 0 t3
Total 7 U; UL,'
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.
ALLOWED 20
IN SUM OF
i '7�
A rJ 12
ON ACCOUNT OF APPROPRIATION FOR
f�tu�
Board Members
PO# or DEPT INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
6 p �7 Q, 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
20 0
Si n ture
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund