We Accept:



Credit Application
Please fill this form out completely.
 We will fax it to you for appropriate signatures.

Firm Name  

Street Address  
P.O. Box  
City  
State  
Zip  
Phone  
Fax  
Principal Line of Work  
Please Choose Business Type  
Name of Bank  
Account Number  
Bank Manager  
Bank Address  
Bank City  
Bank State  
Bank Phone  
List Three Trade References 
Include their Name ,Address, City State,  and  Phone#  
Is a Purchase Order Required?   Yes    No   
Is a Job Number Required?   Yes     No
Damage Waiver Accepted?   Yes      No
   

Damage Waiver- Lessor agrees to waive claim against renter for first $250.00 only, of damage to the rented equipment if the equipment is used in accordance with the lease/rental agreement, and the renter by his initial agrees to pay fee.

   



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