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'DILLARDTRUCKING,IIVG., <br /> d6WDILLARD ENVIRONMENTAL SEFWCES N <br /> x:0:8 4. <br /> RO.BOX 579 - <br /> BYf�ON,CALIFORNIA 94514 <br /> PHONE:(925)634-6850..FAX:(925)6340569 <br /> DATE PM JOB# CUSTOMER x f: CITY IN7 PM <br /> SITE ADDRESS <br /> -� ' <br /> DELIVERY PICKUP TIME UNIT# TYPE RT/OT. LINER TARP <br /> LIST ANY DAMAGE/MISSING PARTS,IN DETAIL <br /> UNIT#`� <br /> TOP 6 CXfL(! <br /> TOP <br /> FRONT FRONT <br /> O LEFT SIDE Q Q LEFT SIDE Q <br /> TOP TOP <br /> FRONT FRONT <br /> Q RIGHT SIDE Q Q , Y:RIGHT SIDE . Q _ <br /> FRONT REAR FRONT REAR <br /> DRIVER SIGNATURE DATE "" TRUCK# <br /> By accepting delive rented items,customer agrees to."all terms and conditions of this rental contract. ` <br /> Customer acknowledges receipt of rented'iOe in good order with exceptions noted above. <br /> CUSTOMER SIGNATURE(*) DATE TRUCK# <br /> 'No one at jobsite to receive units, driver signs for customer. <br /> THIS IS NOT AN INVOICE <br /> ESTIMATED COST FOR REPAIRS: Mailed invoice to follow . <br /> REPLACEMENTTARP F TOP OUTSIDE REPAIRS <br /> REPLACEMENT ARTS <br /> WHEEL(S) HINGES RAILS BODY <br /> DOOR LOCKS TOP PAINT ` <br /> Terms and Conditions: Bills are due and payable within 30 days of invoiced a tb`,We...reserve the right to assess"k.5% <br /> - finance charge per month on past dueaccounts.Customer assumes full responsibifj y'for all rented items,including sale <br /> and proper use,'operation, routine maintenance,and storage.Customer is respot�'for all loss,damage or repair. <br /> WHITE-CLIENT YELLOW-JOB FILE GREEN-ACCOUNTING GOLDENROD-�iSPATCH <br /> , <br />