Auggie
Rental Terms and Conditions
(Please print clearly!)
1) I, ___________________________________, acting on behalf of
________________________________________, take responsibility for
unpacking, any assembly, care, and return packaging and availability of
the unit rented from RJ Cooper & Associates, Inc.
2) I guarantee that any damage incurred during this rental period will
be paid for by ________________________________, with cost dictated by
RJ Cooper & Associates, Inc.
3) I promise to have the unit available for UPS pickup exactly 2 weeks
after receipt. I understand that any delay in this availability
will result in an additional rental period of 2 weeks, which will be
paid for by ___________________________________.
Product that you wish to rent (circle one): Mini-Auggie
Auggie
Super-Auggie
Name of renter:
____________________________________________________________________
Name of renting facility:
_____________________________________________________________
Address:
__________________________________________________________________________
City, State, Zip, Country:
_____________________________________________________________
Phone: __________________ Email:
_________________________________________
Desired rental period:
________________________________________________________________
Method of payment (circle one): Purchase order (mail or fax, no
phone/verbal) or...
Visa MC
AMEX Discover
Card #:
_____________________________________________________
Exp. date: ____________
Name on card:
_____________________________________________________________
Optional $100 insurance (covers everything except drastic physical
abuse) YES
NO
Use your Print button in your browser to
print this form, fill it out, and fax/mail/email to us
RJ Cooper &
Associates, Inc.
27601 Forbes Rd. Suite 39, Laguna Niguel, CA 92677
1-800-RJCooper (800-752-6673)
or dial direct 949-582-2572 Fax: 949-582-3169
Email: infoRJ@rjcooper.com
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