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EQUIPMENT RENTAL REQUEST FORM BCS TWO-WHEEL TRACTOR

  1. EQUIPMENT RENTAL REQUEST FORM BCS TWO-WHEEL TRACTOR
  2. EQUIPMENT REQUESTED:
  3. TRACTOR, PLUS:
  4. Have you already attended the required "EQUIPMENT DEMONSTRATOION WORKSHOP"?
  5. **"All applicable owners manuals will be forwarded to you via email. Please read them prior to your delivery date.
  6. _____ I have read and understand the "Procedures for Rental/Use of the BCS Tractor"
  7. _____ I have completed the "BCS Shared Equipment Lease" agreement.
  8. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  9. I Agree
  10. INTERNAL USE ONLY
  11. Date Request Received: _________________
  12. Received By: ___________________________
  13. Copy of Government Issued ID Attached ______ Yes _______ No
  14. APPROVED:
  15. ____ Yes
  16. ____ Yes, with the following modifications ___________________________________________________________________________________
  17. ____ No (Reason) _____________________________________________________________________________________________________________
  18. 158 Rafters Lane Warrenton, NC 27589 p (252)-257-3640 f (252)-257-5616
  19. Leave This Blank:

  20. This field is not part of the form submission.