The medical equipment is the property of
The Renter may cancel the order before delivery and will be charged twenty-five percent (25%) of the total rental cost. If the order is canceled during the rental period after delivery, no refund will be provided.
The security deposit will be returned after an inspection of the equipment. If the equipment has any damage, the cost of repairs will be deducted from the security deposit. If the security deposit is insufficient to cover the damages, the credit card on file will be charged for the remaining amount. Security deposit refunds may take 4 to 15 business days to process.
The Renter assumes all risk and liability for any loss, damage, injury, or death resulting from the use or operation of the medical equipment.
The Renter is responsible for the full cost of replacement for any damage, loss, theft, or destruction of the medical equipment.
The Renter shall indemnify, defend, and hold harmless
The Renter must immediately notify
The Renter agrees to cover all costs, expenses, and attorney's fees incurred by
The Renter or any driver of the equipment shall not be considered an agent or employee of
Any individual signing this agreement on behalf of a corporation or other entity shall be personally liable for all obligations under this agreement. This agreement is binding upon the heirs, executors, administrators, and assigns of the Renter.
This Agreement shall be governed by and construed in accordance with the laws of the jurisdiction in which
This Agreement constitutes the entire understanding between the parties concerning the rental of medical equipment and supersedes all prior agreements, representations, or understandings, whether written or oral.
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| DESCRIPTION | QTY | UNIT PRICE | TAXES | TOTAL |
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REFUNDABLE UPON RETURN IN GOOD & CLEAN CONDITION |
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| Subtotal | |
| Taxes | |
| Total |
| Card #: |
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| Exp Date: |
/
CVV:
***
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| Cardholder: |
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| Billing Address (if different): | |
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FULL NAME (PRINT)
Name
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SIGNATURE
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DATE
Date
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