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<br /> uu uumcd rr�'t�it'I �umdtym°mm°m t��t�ven ule St Pl�w�t 1, SII' II ,°5117 1 �rrllll I����rul l d d����. t � ����'�" I �,�uru idlcrul.�.„�.�rmu
<br /> Spur°mile°IIB;wt;lipl urm l t':Illiiiurinate t S cuuriiity il°hul nmr.651. ' U7'8 Iil'�ax: 1651,486,64010
<br /> Ifwnue'tui the r~,veir ilrnicreasirn!r arrnuauurnts,of ar irndaliisrre'n and Ipr Iper't,i�r�'m,�r,�ku�rt�ucti irn e c.)ff r:'u`'ouruir cu tmMun-' r �:ar n ge uAm�iilreir of
<br /> ourI( ° n .his darrrlamg ww�ni+ ,4G "s $` rub: 1p t Ilam 110. Iper pm�m�ialty uurnnt per fo four
<br /> week ,: �..�' sir,Stl�;;urnd�ni"
<br /> w�Ireek linull�iirng periiod Thais darnn ge urwl�kf it�w N release you of all repair'dh irvr�r.,�°w�nnith the u;�nrr.ce'lptii n of a $250.00 d'r iduu'ct[bl'e
<br /> for a standaird ur'nrt&$450..00 d duuctiUe for a u path [t?y runit If-the urniit its cornplpet ly a,ii'.11 tr'oye�,„1„
<br /> 111i dpfacrirnr n t cost imMourt Damage liffal'umer4l,*
<br /> R u,rIar unit ,,, $850.00 l,wiur WuniUmm:42,600.100
<br /> Spieldlailty Units Include- Standaird Units Ik'idlbuud �
<br /> * Wheelchair Accessible 0 Mobile �.Ihll°r lil°�
<br /> Maxirn Flush 0 II""'110olk I,.,,IIr�l6°
<br /> 9 !RdHaway Lha,-,mots
<br /> SIr„nICS
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<br /> IIarIrr tFollowing: ” Y"mrcWh' w"r rtrr° tu'I rlbHr")
<br /> t()]eim t:nrc Sissi'm Ia°'r its � rIY fII'„, tiir ainid I1eIntIIIM
<br /> ovil
<br /> I1,,,,iillc.pie O i II„JIrnliits, FIR)ii thiepoiftable rre"'�iutlll°atom s
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<br /> u : ul nl a"' li II!::::: t, bier°' lil ^ II IIIIrI'ot� ii e :� lillrs wit,idl�.,n as: t.lt°,�'oiiw, urr„liu H rin
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<br /> allid seat
<br /> Vf you shmAd dhoo se to d dine the darmnag ww iv r offered by Oin Siite Sai nit tiorn IInc.you there by arcep't'Fuil
<br /> r .sp'o n iIAll'uty-for any and aH dan n grsa destruct.,ion, Ilosso oir theft sof any equipment rented flironn On Site Sanitation.
<br /> IIfyouu choose-to decline'the IDairnage Waiver r 1please complete and return the f rrmn below-tuur office as soon a
<br /> possible. "1'he-form Irm tzq be ireceived in our office.Ibefore.we will rpmove the m g Waiver dharge-Fr m all coin
<br /> Damage Waiver wiillll talke into of the date received ipin our office no re'troactiiura:;credlits will The ii. rued.
<br /> "This Company Chooses to 22dkm the age Waiver**
<br /> As an authorized relpre rntadve of , , II wren d chnirng to take advantage of
<br /> (Com 1p irny o it Agency Na rrn �
<br /> 'm d ,y t tai f0 and that Icl'io�.:)w'ing to damsm�ilirilp the Damage rsurvp.nlr'p
<br /> this company or ar r'w n�a H L eId, u sf o II y uurany and
<br /> all damages,s„ (Ale tr'uurt:iirurn at-, r
<br /> equipment II ".� �w, ���vl n� �rh�p I y it"�rn'n,.�l i I' I'I::W
<br /> mented Froin st un Sutum S�uuruluill t'i,airn putt. a ru�nubhr m r any� rnn 'a�' �swu*r offered n Ori, n
<br /> completely ....h tahr�rft of�mn
<br /> uustorner Name: ,,,,,,
<br /> BRIIiing Address:
<br /> City: State-. Zip,;
<br /> Authorized I rnatu litho „
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