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Home My WebLink About226133 11/18/2013 CITY OF CARMEL, INDIANA VENDOR: 367746 Page 1 of 1 ONE CIVIC SQUARE ONE SOURCE RENTALS CHECK AMOUNT: $170.00 CARMEL, INDIANA 46032 DEPT#30733 o„ PO BOX 790126 CHECK NUMBER: 226133 ST LOUIS MO 63179-0126 CHECK DATE: 11/18/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1093 4350000 80174500001 170 . 00 EQUIPMENT REPAIRS & M Page : 1 One cis Remit To: dtl:ti' iv—S • ",NLES- SER4IC E REC I E DEPT #30733/ONE SOURCE RENTALS OCT 2Q1� P .O. BOX 790126 5520 WEST 96TH STREET ST. LOUIS, MO 63179-0126 ZIONSVILLE, IN 461[1] 765-477-1155 317-733-8010 t� ;---- - Job Site: SALES INVOICE CARMEL-CLAY PARKS&RECREATION 1235 CENTRAL PARK DR.EAST COPY CARMEL, IN 46032 C# : 317-573-4.026 J# : 317-573-4026 Invoice # . . . 8017450-0001 System date . 10/29/13 Customer: IN CARMEL Invoice date 10/29/13 10 :09 AM CARMEL-CLAY PARKS&RECREATION Job Loc . . . . . CARMEL-CLAY PARKS&; 12 5 t 1411 E. 116TH ST Job No. . . . . . 3�6'7q CARMEL, IN 46032 P.O. # . . . . . . MC00� 9 Ordered By. . DAWN KOEPPER -- - Terms . . . . . ****C .O.D. **** Written by. . PAUL LACURE Salesman . . . 02300 Qty Item number Unit Price Amount 1 . 00 8% FUEL SURCHARGE EA . 00 FUEL SURCHARGE 2 . 00 SERVICE LABOR HR 85 . 000 170 . 00 LABOR DELIVERY CHARGE N/C DELIVERY INSTRUCTIONS : Annual inspection of JLG36AM SERIAL # 0900028311 PERFORMED 4-9-13 DROVE TO LOC Sub-total : 170 . 00 ATION AND PERFORMED INSPECTION AND REPAI Total : 170 . 00 RED OUT RIGGER CONTACT THAT WAS STICKING ** ATTENTION ** Amount uncollected: 170 . 00 PAYMENT HISTORY DATE TYPE REF # AUTH ## TRANS TYPE AMOUNT APPLIED 10/29/13 Uncollected 170 . 00 170 . 00 Lessee acknowledges receipt of operating instructions. Lessee assumes responsibility to adequately instruct subsequent operators and will permit only competent and qualified personnel to operate equipment. Lessee acknowledges that during the term of the lease,Lessor has no responsibility over the equipment's proper application,operation and conformance to operating and safety premises. Lessee will cease using equipment and call One Source Equipment Rentals,LLC for serivice if unit fails to operate properly. This piece of equipment shall be used no more than eight(8)hours in any one day,nor more than five(5)days in any one week(except as provided in paragraph 4 hereof). Additional charges may result from neglected maintenance,improper use or excessive clean-up. Rental terminates when One Source Equipment Rentals,LLC is notified and a termination number is assigned. Failure to comply constitutes additional rental charges. All deliveries are subject to the terms and conditions on the reverse side. I have read and agree to the terms of this rental contract and acknowledge receipt of the above stated equipment. X CUSTOMER SIGNATURE DATE NAME PRINTED DELIVERED BY DATE Terms: Payment Due Net 10 -Delinquency charges, at the maximum monthly rate allowed by law, will apply 30 days from the date of invoice. www oHrsouHar,rw a_coM.. 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. One Source Terms Dept# 30733 P.O. Box 790126 St. Louis, MO 63179-0126 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 10/29/13 80174500001 Annual inspection of Lift $ 170.00 Total $ 170.00 1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accoFdance with IC 5-11-10-1.6 20_ Clerk-Treasurer Voucher No. Warrant No. One Source Allowed 20 Dept# 30733 P.O. Box 790126 St. Louis, MO 63179-0126 In Sum of$ $ 170.00 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members Dept# 1093 80174500001 4350000 $ 170.00 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 14-Nov 2013 Signature $ 170.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund