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Equipment Rental Form St. Joseph | ADAMS & Son, Inc. HVAC Mechanical

Equipment Rental

Contact Information

*First Name:

*Last Name:

ADDRESS WHERE EQUIPMENT WILL BE USED

*Address:

*City:

*State/Province:

*Postal Code:

*Phone Number:

*Email:

*Birthdate:

*I'm Interested In Renting:

I Would Like It For The Dates Of:

Start Date

End Date

I am over the age of 25, have a valid MI Drivers license, and do have liability insurance minimum of $500,000.00 & rented equipment coverage minimum of $50,000.00, $55,000.00, or $130,000.00.

Yes

I would like to rent harnesses for a fee of $50.00

Yes

I would like to rent additional attachments for $50.00 each

Yes

I would like to have equipment dropped off for a fee of $100.00

Yes

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