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Rental Information
Rental Request Form
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Request a Rental
Customer Name (LESSEE)
Email Address
Billing Address (Number/Street/City/State/Zip)
Delivery Address (Community/Number/Street/City/State/Zip)
Home Phone Number
Mobile Phone Number
Vehicle Type
2-psgr Golf
4-psgr Neighborhood
4-psgr Premium Neighborhood
4-psgr Lifted Buggy
6-psgr Transport
8-psgr Transport
Light Duty Utility
Med Duty Utility
EMS
2.5kW Inverter/Generator
4.0kW Generator
Note: if multiple vehicle types are required, please call (239) 936-5676 and ask for the Rental Manager
Power
Gas
Electric
Number of Vehicles/Generators Required
1
2
3
4
5
6
7
8
9
10
Note: if multiple vehicle types are required, please call (239) 936-5676 and ask for the Rental Manager
Requested Delivery Date
Rental delivery and pickup is available Monday thru Friday, and subject to schedule availability.
...
Requested Pick-Up Date
Rental delivery and pickup is available Monday thru Friday, and subject to schedule availability.
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Special Equipment Required (if any)
Authorized Drivers:
Driver1 Name
Driver1 Date of Birth:
Driver1 Driver License Number:
Driver1 Driver License State of Issue:
Driver1 Auto Insurance Company:
Driver1 Auto Insurance Policy Number:
Driver1 Auto Insurance Company Phone Number:
Driver2 Name
Driver2 Date of Birth:
Driver2 Driver License Number:
Driver2 Driver License State of Issue:
Driver2 Auto Insurance Company:
Driver2 Auto Insurance Policy Number:
Driver2 Auto Insurance Company Phone Number
Terms and Conditions
PAYMENT and RESERVATION
The undersigned LESSEE will provide the Rental Manager with credit card payment information over the phone to complete the reservation and authorizes the payment of the rental fee per cardholder agreement.
DEPOSIT PAYMENT
In the event of loss or damage over $100.00, the undersigned LESSEE authorizes the immediate payment of a $2,500 deposit per vehicle per the cardholder agreement until such time that a final accounting of the loss or damages can be completed.
LOSS or DAMAGE
LESSEE shall bear all risk of loss or damage to the Vehicle(s) or Equipment from any cause whatsoever and that the LESSEE will, upon expiration or termination of this lease, return all said Vehicle(s) or Equipment to LESSOR in good working order, ordinary wear and tear excepted. LESSEE shall be solely responsible for any loss, theft, damage, fire, destruction, or vandalism by any person, act, or event whatsoever during the lease period. Battery chargers shall be kept away from water or rain at all times.
DAMAGE PAYMENTS
By signing the credit card authorization and rental agreement, the LESSEE authorizes immediate payment for all loss or damages, unless other arrangements have been areeed in writing by both parties, per the following schedule: Bent/Damaged Wheel/Tire: $100 (std.), $350 (prem.); Torn/Damaged Seat bottom/back, or SillyString: $350 each; Bent/Damaged Frame, Transaxle or Engine: $2,500 each; Bent/Damaged Lower Suspension: $300; Bent/Damaged Rack or Column: $750; Damaged Front Body: $400; Damaged Rear Body: $600; Bent/Damaged Roof Support: $250; 56” Roof: $400; 80” Roof: $600; 116” Roof: $800; Mirror: $100; Headlight or Tail Light Assembly: $200 each; Bumper: $200; Windshield: $200; Rocker Panel: $150; Lost Key: $20; Lost Lock or Cable: $50; Total Vehicle Loss: List Price ($7,000 to $12,000); . The LESSOR reserves the right to collect additional damages, fees or charges in connection with said damage, collision, or negligence.
LIABILITY
LESSEE shall assume, defend and at all times indemnify, protect and hold harmless LESSOR against all claims or demands arising of resulting from LESSEE’s use of the Vehicle(s) or Equipment. LESSEE is responsible for any claim of liability public or private arising out of the possession or use of the Vehicle(s) or Equipment during your lease period. LESSOR assumes no liability whatsoever in connection with rentals.
MAINTENANCE
LESSEE shall be responsible for charging or fueling the Vehicle(s) or Equipment, maintaining proper battery electrolyte levels monthly (if equipped), maintaining proper tire pressure, and keeping the Vehicle(s) or Equipment clean and in good order. Any repair expenses caused by abuse or negligent operation, or use of the Vehicle(s) or Equipment for other than intended purposes, will be the responsibility of the LESSEE.
SECURITY
The LESSEE shall operate and store the Vehicle(s) or Equipment only in the community aforementioned, except as stated in writing by the LESSOR. The LESSEE agrees to remove all keys from the Vehicle(s) or Equipment and cable lock the steering wheel with included lock whenever unattended.
SAFETY
The LESSEE agrees that all authorized drivers must be a minimum of TWENTY-FIVE (25) YEARS OLD with a valid driver’s license and valid auto insurance. LESSEE agrees that the Vehicle(s) occupancy will not be exceeded. LESSEE agrees that cargo shall be carried only upon designated Utility Vehicle(s) and not upon passenger carts. In no event shall anything be carried upon the roof of any vehicle at any time. LESSEE agrees to operate the Vehicle(s) or Equipment within the rules and regulations set forth by the aforementioned community.
COLLECTIONS
If LESSEE fails to pay when due any rent or other amounts required under this lease, LESSEE shall pay to LESSOR a service charge of 5% of the delinquent amount, or USD$10.00, whichever is greater, plus interest of 1.5% per month from the due date until the date paid. In the event that this lease is referred to LESSOR’s Attorney or Small Claims Court to collect any amounts due hereunder, or to gain possession of the Vehicle(s), or to enforce any other rights of the LESSOR, LESSEE agrees to pay LESSOR all reasonable Attorney’s or collection fees in connection therewith.
Accept or Decline
Accept
Decline
Subject to acceptance at the sole discretion of Coastal Carts, the following constitutes a legal agreement between the LESSEE and LESSOR once it has been electronically signed and submitted by the LESSEE.
LESSEES TYPED ELECTRONIC SIGNATURE:
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