Approval of State Revolving Fund (SRF) Planning and Design Reimbursement #1 – Water Treatment Plant — E-7

AERO RENTAL And Party Shoppe 227 Kirkwood Ave Iowa City, IA 52240 319-338-9711 Customer #: 9180 Phone 319-545-2572 Status: Closed Invoice #: 313146 Invoice Date: Mon 5/15/2023 Date Out: Mon 5/15/2023 9:00AM Operator: John Terms: On Account City of Tiffin PO Box 259 Tiffin, IA 52340 Ordered By: Nate Wessling 319 359-8289 Delivery Mon 5/15/2023 9:00AM Nate Wessling 319-359-8289 Water Treatment Plant TIFFIN, IA 52340 Call Nate on the way. Pickup Mon 5/15/2023 12:45PM Nate Wessling 319-359-8289 Water Treatment Plant TIFFIN, IA 52340 <table> <tr> <th>Qty</th> <th>Items Rented</th> <th>Each</th> <th>Status</th> <th>Returned Date</th> <th>Price</th> </tr> <tr> <td>1</td> <td>Boom 46' Snorkel AB46JRT #1<br>Meter Out: 687.0<br>1day $290.00 1week $870.00 4weeks $2,610.00<br>Meter In: 688.0 Total hours on meter: 1.0</td> <td>$290.00</td> <td>Returned</td> <td>Mon 5/15/2023 12:43PM</td> <td>$290.00</td> </tr> </table> Lift Rentals: Renter assumes the responsibility and all costs associated for any physical damage to the lifts cage and platform. Renter assumes all responsibility and all cost associated with fallen debris. DAMAGE WAIVER WILL NOT APPLY IN THESE CIRCUMSTANCES. <table> <tr> <th>Qty</th> <th>Items Sold</th> <th>Each</th> <th>Price</th> </tr> <tr> <td>1</td> <td>Delivery/Pickup (Equipment)</td> <td>$200.00</td> <td>$200.00</td> </tr> </table> RECEIVED MAY 15 2023 By [signature] Please pay from this invoice. Thank you for your business. Card Payments will incur a 3% convenience fee. Rental Contract 1. SEE THE REVERSE SIDE FOR ADDITIONAL TERMS AND CONDITIONS. This is a contract. The reverse side of this contract contains important terms and conditions including lessee's disclaimer from all liability for injury or damage and details of customer's obligations. 2. This agreement supersedes any purchase order or other document provided by you to us. 3. Minimum rental will be charged if equipment leaves our premises. 4. You are renting Equipment "AS IS". 5. In the event that any Equipment is damaged, becomes unsafe, malfunctions, or requires repair, immediately discontinue the use thereof and contact us immediately. You will be charged for all time proceeding you contact us. 6. You may be subject to civil and criminal penalties if you fail to return the rented property. Damage Waiver is 10% of the gross rental charges I agree to be bound by the terms of this Agreement which includes the terms and conditions printed the reverse side hereof. Signature: ____________________________ City of Tiffin <table> <tr> <th>Rental:</th> <td>$290.00</td> </tr> <tr> <th>Damage Waiver:</th> <td>$29.00</td> </tr> <tr> <th>Delivery Charge:</th> <td>$200.00</td> </tr> <tr> <th>Subtotal:</th> <td>$519.00</td> </tr> <tr> <th>Total:</th> <td>$519.00</td> </tr> <tr> <th>Paid:</th> <td>$0.00</td> </tr> <tr> <th>Amount Due:</th> <td>$519.00</td> </tr> </table>