Fillable Equipment Rental Form printable pdf download

EQUIPMENT RENTAL FORM

PLEASE PRINT CLEARLY

CURRENT CLIENT

Name:

______________________________________________

2630 LANCASTER ROAD UNIT E

Company: ______________________________________________

OTTAWA ON

K1B 5L8

Address: ______________________________________________

(613) 731-ROPE (7673)

City: _____________________Prov/State: ____________________

Postal Code/Zip:_____________ Cell: ____________

(613) 731-8747 fax

Office: ________________ Fax: _______________

EQUIPMENT RENTED

SERIAL NUMBER

$ / WEEK(S)

$ / DAY(S)

TOTAL

1.______________________________________________________________________________________

2.______________________________________________________________________________________

3.______________________________________________________________________________________

4.______________________________________________________________________________________

INCLUDED WITH RENTAL:

Storage Box

Tubing

Water Stop

Filters

Certificates

Instructions

Batteries

Charger

SRL RENTAL:

SRL Bracket

Pulley

Seatbelt Lanyard

Spreader Bar

Steel Cables

Carabiners # _____

Harnesses # _____

Rented by (print): _______________________________________ Date: ____________________________

Signature: ____________________________________________ Time: ____________________________

Returned by (print): _____________________________________ Date: ____________________________

Signature: _____________________________________________ Time:____________________________

CHECK SRL FOR DEPLOYMENT

Initials ____ PAYMENT METHOD

ALL ITEMS RETURNED

SUB-TOTAL $_________________

Payment:

Cheque

Mastercard

Visa

P.O. #______________________

+ GST/HST $_________________

Credit Card #

______________________________________________________

+ QST

$_________________

Expiry date:

__________________ Auth #______________________________

TOTAL $_________________

Cardholder Name:________________________ Signature : ____________________

DATE __________________

COMMENTS: ______________________________________________________

RENTAL TERMS AND CONDITIONS

Please Read Carefully

Deposit must be paid for in full at the time of pick-up; payment can be made with cash, Visa, M/C or Amex. Valid photo

identification (driver's license or passport) must be shown for all rentals. Rentals returned late will be charged the single day rate

for each day late. If rental equipment is returned in damaged or dirty condition, the renter will be responsible for cleaning and

repair costs; expenses incurred under this policy will be charged to the deposit. Rentals will be billed at a daily or weekly rate,

whichever is less. The minimum time period is one day. After the initial 24 hours, you will be billed for the second day and

charged another day’s rate every 24 hours thereafter. There will be an additional charge if delivery to your site is required.

If the air monitor reads off-line "OL" / out-of-range "OR" due to atmospheric test results, a re-calibration fee of $ 85.00 will be

applied to your invoice; if a sensor(s) is deactivated and rendered unusable, a replacement sensor(s) will be invoiced. Thank you.

Should the retractable lifeline arrest a fall, a re-certification minimum charge of $ 450.00 will be applied.

A deposit of $ 1,000.00 is required when the rental item(s) are picked-up. Add applicable taxes to above rates.

When the rented equipment is returned, the deposit amounts will be reimbursed, less any damage, cleaning, or late charges.

Any lost, stolen or damaged equipment will be billed at replacement costs. VISA, MasterCard & American Express: Welcome!

SIGNATURE: ______________________________________________ DATE: __________________________

I agree to the above terms and conditions.

equipment rental web form.pdf

Rev. Feb / 11

(Signature(s) will be required when the equipment is picked-up)

SUBMIT FORM

Equipment Rental Form

Related Articles

Related forms

Related Categories