227487 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 354867 Page 1 of 1
ONE CIVIC SQUARE RUNYON EQUIPMENT RENTAL CHECK AMOUNT: $18.90
CARMEL, INDIANA 46032 410 W CARMEL DRIVE
,ti_TON`o CARMEL IN 46032 CHECK NUMBER: 227487
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 288440-1 18 . 90 BOTTLED GAS
IIIIII VIII VIII VIII VIII VIII IIII IIII Page 1 of 1
Status:410 WEST CARMEL DRIVE �i�OSe
®� Invoice#: 288440-1 1
CARMEL,IN 46032 Invoice Date: Mon 1219/2013
EQUIPMENT RENTAL www.runyonrental.com Date Out: Mon 12/9/2013 2:46PM
1-800-276-Tool(8665) 317-566-8888 Phone
"Don't be a fool-Rent one` 317-566-2990 Fax Operator: BRIDGETTE ELMORE
Customer#: 1384
Terms: On,Account
CARMEL STREET DEPARTMENT 317-733-2001 Phone
317-733-2005 Fax
3400 WEST 131ST STREET
CARMEL,IN 46074 Job No: PATCHWAGON
Open Monday-Friday 7:00am-5:30pm,Saturday 7:00am-4:30pm,Sunday 9:00am-3:00pm
Picked up by: STUBBS, CHRISTOPHER
Salesman: NONE
Qty I Key Items Ser# Status Returned Date Price
5.40 7-1 PROPANE BULK Pulled $18.90
Thank You for your Business
Rental: Damage Waiver: Sales: Delivery Charge: Misc Charges:
$0.00 $0.00 $18.90 $0.00 $0.00
Subtotal: INDIANA: Total: Paid: Amount Due:
$18.90 $0.00 $18.90 $0.00 $18,90
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 l,(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 STREET DEPARTMENTSTUBBS,CHRISTOPHER
Modification# 1
Printed On Mon 12/9/2013 5:41.10PM Soflware by Point-of-Rental Systems www.point-of-rental.com Contract-Params.rpt(1)
VOUCHER NO. WARRANT NO.
ALLOWED 20
Runyon Equipment Rental
IN SUM OF $
410 W. Carmel Drive
Carmel, IN 46032
$18.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I 288440-1 I 42-311.001 $18.90 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
r b , 2013
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/09/13 288440-1 $18.90
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