
Commercial Trailer Rental Agreement (Primary)
Renter Phone # Cell #
Address City State Zip
Driver's
License No.
State
Exp. Date
Birth Date Social Security No.
Employer Address Phone Number
Renter's Insurance Carrier Agent Phone Number
Additional Drivers: Name
Age License Number
Model License Number State Vehicle Number
Time Out Date Date Deposits Received Amount
Time Due In Date Reservation Deposit
$
Time Actual In Date Damage Deposit $
Mileage Out Mileage In
Total Time Total Mileage
At Time of Check Out At Time of Check In
Milage taken from odometer installed Hours @ $ Actual Hours @ $
by manufacturer Days @ $ Actual Days @ $
Charges for late return of Trailer_________per day or Weeks @ $ Actual Weeks @ $
___________per hour whichever is highter
Est. Miles @ $ Actual Miles @ $
We provide physcial damage insurance covering Package Rental $ Package Rental $
damage to the Trailer with a Dealers Deductible of Sub-Total $ Sub-Total $
$________ . If the Trailer is damaged, you are Tax % $ Tax % $
responsible for the Dealers Deductible amount. Cleaning Charge $ Cleaning Charge $
MBA 2008 - Commercial Trailer
Generator Charge $ Generator Charge $
( ) RD Reflectors ( ) ( )
( ) $
( ) Flares ( ) ( )
( ) $
Total Charge $
( ) Fire Extinguisher ( ) ( )
( ) $
Less Deposit $
( ) Spare Tire ( ) ( )
( ) $
Due at
( ) Electric Cord ( ) ( )
( ) $
Check In
$
( ) Gas Bottle & Reg. ( ) ( )
( ) $
( ) Keys ( ) ( )
( ) $
Estimated Damage $
( ) Jacks ( ) ( )
( ) $
Total Additional
( ) Safety Chains ( ) ( )
( )
Total Advance Charges $
( ) Hitch ( ) ( )
( )
Charges
$
( ) Brake Connection ( ) ( )
( )
Less Advance
( ) Resistor ( ) ( )
( )
Payment Deposit
$
( ) Ball ( ) ( )
( )
Advance
( ) El Plug ( ) ( )
( )
Payment Due
$
( ) License Plate ( ) ( )
( )
Received By:
At Checkout
( ) H-Springs ( ) ( )
( )
You have notified your insurance agent of your intention to
You have carefully examined the Trailer wheels and hitch and
haul the Trailer. You have been advised by your agent
found them both satisfactory.
that your liability and property damage insurance covers your
YOUR INITIALS__________
risk of liability for injury or damage to others or their propert
and your insurance policy have been endorsed accordingly.
B
si
nin
below
ou acknowled
e that
ou have been
iven an o
ortunit
to read the Term and Conditions
of this Agreement before being asked to sign. Your signature authorizes us to process a credit card voucher for
all charges due us under this agreement, including later payment of any traffic,toll or parking violations assessed
a
ainst the Trailer.
X X
MBA 2008 - Commercial Trailer