Marrëveshja e makinave me qira

Për një automjet të përkohshëm

Customer Name: Informacioni i automjetit me qira

Home Address: Rental Car VIN:

1D4GP253X3B221657 or 1GMDU23E12D138288
City State Zip License No:
CH8 N4F or CH8 N3F
Driver’s License No State Expires State: MO

Birth Date Telephone Year/Make/Model:

2003 Dodge Caravan
E-mail Or 2002 Pontiac Montana

Date OUT: Date DUE IN:

Mileage OUT: Mileage IN:

Customer Vehicle Insurance Information Car Rental Rate:

Auto Insurance Company $___________/weekly or

$___________/daily
Policy No. Expires
Gas Tank Reading:
Agent Telephone
Full ¾ ½ ¼
Insured Vehicle Year/Make/Model/Color Miles Allowed: ____________ per day

Vehicle Condition Out: No Damage Damage Description Time & Mileage Charges

Vehicle Condition In: No Damage Damage Description Taxable Fuel GAL. @ $

_______ Customer will fill the fuel tank at the indicated level before return of the Vehicle. Additional Driver Fee:
Failure to refill the tank will result in a charge of $20.00 per quarter tank of fuel.
Subtotal
_______ Customer is responsible for lost car keys, a lockout situation, including electronic Tax @ %
keys, remotes, and programming
Total Charge
If Your vehicle is being serviced by Us, Our right to repair Your vehicle during this rental is Payment
considered by Us to be the rental fee. You agree to all the terms and conditions on both $___________________________
sides of this Agreement and You acknowledge You were given an opportunity to read this Check #________________________________
Agreement before You were asked to sign. You authorize Us to process a credit/debit card AE MC V Other__________
voucher in Your name for all charges due under this Agreement. Your signature below is Credit Card No:_________________________
considered made on the applicable credit/debit card voucher. Exp:____/_____ Security Code:__________

YOUR SIGNATURE: ALL CHARGES SUBJECT TO FINAL AUDIT.

For after hours roadside assistance or towing call:

Budget Towing (636) 395-4819

 Rental Agreement Terms and Conditions
1. Definitions. “Agreement” means all terms and conditions found on both sides 6. Insurance. You are responsible for all damage or loss You cause to others.
of this form and on any other documents we give You at the time of rental. “You” or You agree to provide auto liability, collision and comprehensive insurance covering
“Your” means the person identified as the customer on the reverse side of this You, Us, and the Vehicle. Your insurance may cover all or only part of the financial
Agreement, any person signing, this Agreement, any Authorized Driver and any liability for the Vehicle. You should check with Your insurance company to find out
person or organization to whom charges are billed by Us at its or the customer’s about your coverage. Your insurance is primary. However, if You have no auto
direction. You are jointly and severally bound by this Agreement. “We”, “Us” or “Our” liability insurance in effect on the date of a loss, or if We are required by law to
means the independent dealer named elsewhere in this Agreement. “Vehicle” means provide liability insurance, We provide auto liability insurance (the “Policy”) that is
the automobile identified in this Agreement and any vehicle We substitute for it, and secondary to any other valid and collectible insurance whether primary, secondary,
all its tires, tools, accessories, equipment, keys and documents. The Vehicle is a excess, or contingent. The Policy provides bodily injury and property damage liability
temporary substitute for a vehicle that You own or lease. “Authorized Driver” coverage with limits no higher than minimum levels prescribed by the State whose
means: (a) the customer, provided that the customer is the registered owner or laws apply to the loss. You and we reject PIP, medical payments, no-fault, and
lessee of the vehicle being serviced by Us and for which Our Vehicle is a substitute, uninsured and under-insured motorist coverage, where permitted by law. The
and that such person is at least age 21; (b) additional drivers listed by Us elsewhere Policy is void if You violate the terms of this Agreement or if You fail to cooperate in
in this Agreement, provided that each such additional driver is at least age 25; (c) the any loss investigation by Us or Our insurer. Giving the Vehicle to an unauthorized
customer’s spouse, provided that such person is at least age 21; and (d) if the driver terminates Our liability insurance coverage, if any.
customer is a corporation or other business entity, Authorized Driver includes an
employee of the customer who is a permissible driver on the business entity’s 7. Charges. You will pay Us, or the appropriate government authorities, on
business auto insurance policy, provided each such employee is at least age 21. demand, all charges due under this Agreement, including: (a) time and mileage for the
Every Authorized Driver must possess a valid driver’s license. Only Authorized period that You kept the Vehicle; (b) applicable taxes; (c) $50 or the maximum
Drivers may drive the Vehicle. “Loss of Use” means the loss of Our ability to use the amount permitted by law, whichever is greater, if You pay Us with a check returned
Vehicle for any reason, due to damage to it or loss of it, during this transaction; Loss unpaid for any reason; (d) $30 per day or the maximum amount permitted by law,
of Use equals a reasonable estimate of the income We lost while the Vehicle was out whichever is greater, for each day You do not return the Vehicle by the Date Due In;
of service for repair or replacement. (e) all parking and traffic fines, toll violations, penalties, citations, forfeitures, court
costs, towing, storage, impound charges and other expenses involving the Vehicle
2. Rental; Indemnity and Warranties. This is a contract for rental of the Vehicle. In assessed against Us or the Vehicle; if You fail to pay a parking, traffic or toll charge to
addition to any rental charges stated in this Agreement, Our right (or the right of Our the charging authority, You will pay Us all fees owed to the charging authority plus
affiliate), to repair Your vehicle is consideration paid to Us for this rental. We may Our administrative fee of $50 for each such violation; (f) all expenses We incur
repossess the Vehicle at Your expense without notice to You, if the Vehicle is recovering the Vehicle if it is not returned to the renting location; (g) all costs,
abandoned or used in violation of law or this Agreement. You agree to indemnify Us, including pre- and post-judgment attorneys’ fees, We incur collecting payment from
defend Us and hold Us harmless from and against, all claims, liability, costs and You or otherwise enforcing Our rights under this Agreement; (h) a 2% per month late
attorneys’ fees we incur resulting from, or arising out of, this Agreement or Your use fee on all charges due Us but not paid when due; (i) a reasonable fee to clean the
of the Vehicle. We make no warranties, express, implied or apparent, regarding Vehicle, not to exceed $250, if returned substantially less clean than when rented or if
the Vehicle, no warranty of merchantability and no warranty that the Vehicle is it is determined that You or Your passengers smoked inside the Vehicle or
fit for a particular purpose. transported animals inside the Vehicle; and (j) fuel and a refueling fee if You return
the Vehicle with less fuel than when rented. You authorize us to process Your credit
3. Condition and Return of Vehicle. You must return the Vehicle to Our office or card for all charges, and by signing this Agreement, You are also signing all
other location We specify, on the date and time specified in this Agreement, in the documents required to process Your credit card.
same condition that You received it, except for ordinary wear. If the Vehicle is
returned after closing hours, You remain responsible for any damage to the Vehicle 8. Deposit. We may use Your deposit, if any, to pay amounts owed to Us under
until We inspect it on reopening for business. Service to the Vehicle or replacement this Agreement.
of parts or accessories during this rental must have Our prior approval.
9. Your Property. You release Us, Our agents and employees from all claims for
4. Responsibility for Damage or Loss; Reporting to Police. You are responsible for loss of, or damage to, Your personal property or that of any other person, that We
all damage to, or loss or theft of, the Vehicle, including damage caused by weather, received, handled or stored, or that was left or carried in or on the Vehicle or in any
road conditions, and acts of nature, whether or not You are at fault. You are service vehicle or in Our offices, whether or not the loss or damage was caused by
responsible for the cost of repair, or the actual cash retail value of the Vehicle, on the Our negligence or was otherwise Our responsibility.
date of the loss if the Vehicle is stolen, not repairable, or if We elect not to repair the
Vehicle. You are also responsible for Loss of Use, and Our administrative expenses 10. Breach of Agreement. You waive all recourse against Us for criminal
incurred processing the claim. You are responsible for replacing missing equipment prosecutions We take against You for breach of this Agreement.
and Vehicle documents. You must check and maintain all fluid levels. You must
report all accidents or incidents of theft and vandalism to Us and the police as soon as 11. Modifications. No term of this Agreement can be waived or modified except by
You discover them. a writing that We have signed. If You wish to extend the rental period, You must
return the Vehicle to Our office for inspection and written amendment by Us of the
5. Prohibited Uses. The following uses of the Vehicle are prohibited and Date Due In. This Agreement constitutes the entire agreement between You and Us.
constitute breaches of this Agreement. The Vehicle shall not be used: (a) by All prior representations and agreements between You and Us regarding the use of
anyone who is not an Authorized Driver or not licensed to drive, or by anyone the Vehicle are void.
whose driving license is suspended; (b) by anyone under the influence of
alcohol, prescription or non-prescription drugs; (c) by anyone who obtained the 12. Miscellaneous. A waiver by Us of any breach of this Agreement is not a waiver
Vehicle, or extended the rental period by giving Us false, fraudulent, or of any additional breach or waiver of the performance of Your obligations under this
misleading information; (d) under any circumstances that could be properly Agreement. Our acceptance of payment from You or Our failure, refusal, or neglect to
charged as a crime other than a minor traffic violation; (e) to carry persons or exercise any of Our rights under this Agreement does not constitute a waiver of any
property for hire; (f) to push or tow anything; (g) in any race or speed contest; other provision of this Agreement. Unless prohibited by law, You release Us from any
(h) to teach anyone how to drive; (i) outside the United States or the geographic liability for consequential, special, or punitive damages in connection with this
area described elsewhere in this Agreement; (j) on any unpaved surface; (k) transaction or the reservation of a vehicle. If any provision of this Agreement is
when the odometer has been tampered with or disconnected; (l) when it is deemed void or unenforceable, the remaining provisions are valid and enforceable.
reasonable to expect You to know that further operation of the Vehicle would This Agreement shall be governed and construed by the laws of the State of Missouri
damage it; (m) where applicable, by anyone who lacks experience driving a without regarding to its conflicts and choice of law provisions.
vehicle equipped with manual transmission; and (n) to transport an animal.