223182 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 354867 Page 1 of 1
ONE CIVIC SQUARE RUNYON EQUIPMENT RENTAL
CARMEL, INDIANA 46032 410 W CARMEL DRIVE CHECK AMOUNT: $41.80
CARMEL IN 46032
CHECK NUMBER: 223182
CHECK DATE: 8/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 272571-1 41 . 80 OTHER EXPENSES
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Status: Closed
410 WEST CARMEL DRIVE Invoice#: 272571-1
CARMEL, IN 46032 Invoice Date: Mon 7/15/2013
EQUIPMENT RENTAL www.runyonrental.com Date Out: Mon 7115/2013 1:44:OOPM
1-800-276-Tool(8665) 317-566-8888 Phone
"Don't be a tool-Rent one" 317-566-2990 Fax Operator: MEL SPROUSE
(Customer-9985—� Terms: On Account
CARMEL WASTE WATER 317-571-2634 Phone
760 3RD AVENUE SW
SUITE 110
CARMEL, IN 46032
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm, Sunday 9:00am-3:00pm
Ordered By: Picked up by: MALLABER, BLAINE
Salesman: NONE Phone: -- E-Mail:
Qty Key Items Ser# Status Returned Date Price
21101-1 PROPANE 30 POUND REFILL Pulled $41.80
JUL 2 6 2013
gy-
�a 75o z a od
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$0.00 $0.00 $41.80 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$41.80 $0.00 $41.80 $0.00 $41.80
You understand that:(a)it is unauthorized for me to lend the Rented Item(s)to any other person;(b)THE RENTED ITEM(S)IS/ARE FULL OF FUEL AND MUST BE RETURNED AS
SUCH OR ADDITIONAL CHARGES WILL APPLY(c)use of alternative fuels(e.g.Biodiesel,E85,etc.)in Rented Item(s)is prohibited and you are responsible for all damages and repairs
resulting from alternative fuel;(d)no electrical tools are supplied with safety grounded plugs for use in grounded outlets(except for double-insulated safety-approved tools),and you are
responsible for not cutting off the ground lug;(d)Runyon is authorized to charge my debit or credit card for all amounts coming due hereunder,including for damage to the Rented Item(s)
which is discovered after the Rented Item(s)have been returned;and(e)labor rate is charged at$85.00 per hour. X (Initial)
I have been instructed and demonstrated on the safe and proper operation of the above equipment,and I fully understand those instructions. X (Initial)
I have provided Runyon with proof of insurance(insurance that covers all damage to or loss of Equipment)and am declining the Equipment Protection Plan(Damage Waiver)as
described on the back of this Contract.x (Initial)
The undersigned has carefully read and fully understands the Terms and Conditions on the back of this Contract and personally guarantees the Customer's prompt payment and
performance of its obligations arising under this Contract.
Printed Name:
Signature:
CARMEL WASTE WATER-MALLABER, BLAINE
Modification jj$- 1
WE Printed On MoRGEs OoR3TIME 5.0 PNi NOT TlfviE USED. YOU ARE RESPONSIBLE FOR aALL s TIRES,�Upoi A oPr ELECTRIC a CURRENT. RENTAL FEES DO NOT APPLYCo tral a msFp�•(t)
NO ADJUSTMENTS USri�)T�E ��i�Pie maae can equipment mafunrc ons unless Runyon has been notified.
Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
354867
RUNYON EQUIPMENT RENTAL Purchase Order No.
410 W. Carmel Drive Terms
Carmel, IN 46032 Due Date 8/6/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/6/2013 272571-1 $41.80
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
(�PA/3
Date Officer
VOUCHER # 136123 WARRANT # ALLOWED
354867 IN SUM OF $
RUNYON EQUIPMENT RENTAL
410 W. Carmel Drive
Carmel, IN 46032
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
272571-1 01-7202-06 $41.80
Voucher Total $41.80
Cost distribution ledger classification if
claim paid under vehicle highway fund