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Name: ____________________________ Phone #: _____________________ Date: __________

Address: _________________________________ City: ___________________ Zip: __________

DL# _______________________ State: _____ Expiration: ________________ DOB: __________

Insurance Co: ________________________________ Policy # ___________________________

Ins. Expiration: ________________________ Agent Phone # ____________________________

Item included

Out

In

Cost

Item included

Out

In

Cost

2 steel ramps with (2) pins

 

 

$150 each

Winch remote

 

 

$60

2 wood extension ramps

 

 

$40 each

Snatch block

 

 

$20

Tongue mounted tool box

 

 

$250

5 HD ratchet straps

 

 

$20 each

Breakaway cable

 

 

$10

Recovery tow strap

 

 

$20

Set of keys

 

 

$20

4 axle straps

 

 

$10 each

Spare Tire

 

 

$125

Ball hitch lock

 

 

$20

Steel wheel

 

 

$80

Hitch pin lock

 

 

$20

Spare tire tool kit

 

 

$30

Tire pressure gauge

 

 

$15

4 ton bottle jack

 

 

$30

2 rear stability jacks

 

 

$80 each

12,000 lbs winch

 

 

$350

12 volt battery

 

 

$100

Gloves

 

 

$15

 

 

 

 

Rate $______x _____days/hours

 

Deposit              $ 150

 

2 5/16” HD hitch rental       ($10)

 

Delivery/Pick up charge   Y/N

 

6.75% sales tax

 

3% processing

 

Due at delivery

 

Damages

 

Clean up fee $20

 

Late fees ($30 per hour)

 

Balance due at return

 

              Trailer OUT:

   Date: _________ Time: _______

  • Initials: _________

              Trailer IN:

   Date: _________ Time: _______

  • Initials: _________

 

  • __________ I acknowledge receiving all items above and know that I am responsible for returning all items in good working condition or else I will be expected to pay for that item.

  • __________ I have carefully inspected the trailer, tires, hitch and find them all in satisfactory condition.

  • __________ I understand that I am responsible for any and all damages up to and including theft.

By signing below, you acknowledge that you have been given an opportunity to read the Terms and Conditions of this Agreement before being asked to sign. Your signature authorizes us to process a credit card voucher for all charges due to us under this agreement, including later payment of any traffic, toll or parking violations assessed against the Trailer while in your possession.                                                                       

X__________________________________________                                                      Date_____________________

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