Backflow Services Rancho Cucamonga, CA

FORM

Rental Agreement

Assembly Information

code 3 $10.00 per day code 2 $5.00 per day code 4 $ per day

Approximate duration of rental days. Rental fee will be collectable every 30 days.

If replacement of any damaged parts is needed to return the assembly to operating condition, the deposit may be used toward these costs. Customer will be responsible for any costs more than the deposit to repair or replace the assembly and/or connection equipment. Dakota reserves the right to end rental agreement at any time. Rental payments required in advance every 30 days.

I accept responsibility and liabilities for the use and care of this equipment from damage, vandalism, or theft. A $200.00 fee will be added for disconnection or relocation without prior authorization by Dakota Backflow.

Attatch Signature

Visa Mastercard

Rental Prices

2" Hydrant

$275.00 Fee to set & Certify (Per Assembly) *plus travel time
$5.00 per day / 30 day minimum = $150.00

$275.00

$150.00

$425.00 (Total Price)

To Install Plus travel time, payable upon completion.

$150.00 Pick-Up Fee - *plus travel time. 3 day notice required.

$425

2 1/2" - 6" Hydrant

$375.00 Fee to set & Certify (Per Assembly) *plus travel time
$10.00 per day / 30 day minimum = $300.00

$375.00

$300.00

$675.00 (Total Price)

To Install Plus travel time, payable upon completion.

$150.00 Pick-Up Fee - *plus travel time. 3 day notice required.

$675

*Travel time will be added if installation is over 60 miles @ $125.00 per hour.

IMPORTANT NOTICE

It is mandatory to notify Dakota Backflow Company 3 DAYS IN ADVANCE
IN WRITING

By Certified MAIL or EMAIL when rental is done and ready for pick up. If by phone, you must have a confirmation number. No Voice Mail or phone messages are acceptable.

Customers renting equipment from Dakota Backflow Company are not allowed to move equipment from any site or location from which it was installed. DO NOT disconnect the assembly from the meter.

If the Agent or Employee accepting or signing for equipment separates from the company, changes location, or changes position within company, Dakota Backflow Company must be notified in writing by the company.

The new responsible person on location of rental must notify our office that he/she has knowledge of rental equipment and terms for rental. Failure to comply may result in additional costs.

I have read the terms for rental and do agree to follow the procedures.