CREDIT CARD BY FAX AUTHORIZATION

U-Cart Concrete TO-GO

711 N. La Brea Ave.
Inglewood, CA 90302-2203
800/300-RENT (7368), 310/677-7600, FAX: 310/677-7857

WE CAN NOT PROCESS INCOMPLETE FORMS!

MUST SEND: Fax copy of CALIFORNIA (only) Driver License and copy of Credit Card being referenced below.


 

The person(s) listed below are hereby authorized to act on behalf of Customer/Company listed above in connection with the rental of equipment, tools and other property from Quality Equipment Rentals and to conduct any and all other related business on behalf of the Customer/Company. Customer/Company agrees to be fully bound by the terms and conditions of the Rental Contract and any other agreement, waiver, acknowledgment, receipt or other authorization executed or otherwise agreed to by such person(s) as if duly authorized and agreed to by Customer/Company themselves. Customer/Company acknowledges and agrees that this authorization is a continuing one and shall apply to the rental of all items of equipment, whether identified in the Rental Contract or subsequently obtained by such persons(s) from Quality Equipment Rentals and Customer/Company agrees to timely pay all rental and other charges incurred therewith.

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