Equipment Hire Form Hire Agreement FormCUSTOMER DETAILSPlease provide the below detailsNameAddressPhone EmailABNDrivers Licence NumberImage of Drivers Licence FrontChoose File Image of Drivers Licence BackChoose File HIRER DETAILSEMPIRE SOLUTIONS Name: Empire Solutions Co Pty Ltd ABN 52 652 882 776 (Empire Solutions)Address: 18 Durham Place, Glenview 4553 , AustraliaContact Email: empiresolutionscoptyltd@gmail.com EQUIPMENT HIREPlease select the equipment you are hiringEquipment Excavator U17-3 KUBOTA EXCAVATOR U17-3HGMachine: U17-3HG ExcavatorMake: KubotaModel: U17-3HGVIN/PIN: KBCAZ24CCP3C58407Serial#: 58407Engine#: 4PE8430Engine hours: NAHire Rate: $170 + GST per dayPlease select hire period Day Rate $170 + GST per day Weekend $300 + GST per weekend 3 Days + $150 + GST per dayTick below if you would also like to hire the Auger or Scissor Clamp Auger hire additional $45 + GST per day Scissor Clamp hire additional $35 + GST per dayEquipment Excavator U17-5 KUBOTA EXCAVATOR U17-5 PREMIUMMachine: U17-5 Premium ExcavatorMake: KubotaModel: U17-5VIN/PIN: KBCAZ226CKR3M10387Serial#: 77443Engine#: 4RX1559Engine hours: NAHire Rate: $185 + GST per dayPlease select hire period Day Rate $185 + GST per day Weekend $330 + GST per weekend 3 Days + $160 + GST per dayTick below if you would also like to hire the Auger or Scissor Clamp Auger hire additional $45 + GST per day Scissor Clamp hire additional $35 + GST per dayEquipment Tipper ISUZU TIPPER TRUCKMachine: Manual Tipper TruckMake: IsuzuModel: White Isuzu NMR 45-150Serial#: JAANMR85EM7101229Engine#: 4JJ1215561Engine hours: NAHire Rate: $185 + GST per dayEquipment Tipper U17-3 Excavator Combo TIPPER TRUCK + U17-3 EXCAVATOR COMBOMachine: U17-3HG ExcavatorMake: KubotaModel: U17-3HGVIN/PIN: KBCAZ24CCP3C58407AS LISTED ABOVEMachine: Manual Tipper TruckMake: IsuzuModel: White Isuzu NMR 45-150AS LISTED ABOVEHire Rate: $320 + GST per dayTick below if you would also like to hire the Auger Auger hire additional $45 + GST per dayEquipment Tipper U17-5 Excavator Combo TIPPER TRUCK + U17-5 EXCAVATOR COMBOMachine: U17-3HG ExcavatorMake: KubotaModel: U17-3HGVIN/PIN: KBCAZ24CCP3C58407AS LISTED ABOVEMachine: Manual Tipper TruckMake: IsuzuModel: White Isuzu NMR 45-150AS LISTED ABOVEHire Rate: $335 + GST per dayTick below if you would also like to hire the Auger Auger hire additional $45 + GST per dayEquipment Auger AUGER HIREMachine: Auger TorqueModel: X2000Weight: 47kgHire Rate: $60 + GST per dayEquipment Scissor Clamp SCISSOR CLAMPMachine: AbacoMake: Scissor ClampModel: SC100Hire Rate: $45 + GST per dayEquipment Crew Truck CREW TRUCKMachine: Make: IsuzuModel: 45-150 Crew IFSVIN/PIN: Serial#: Engine#: Engine hours: NAHire Rate:Equipment Toyota Hilux TOYOTA HILUX 4X4Machine: Make: ToyotaModel: HiluxVIN/PIN: Serial#: Engine#: Engine hours: NAHire Rate: $125 + GST per dayTools TOOLSPlease select which tools you would like to hire: Jackhammer $75 + GST per day Flex Motor $50 + GST per day Concrete Whip $50 + GST per day Concrete Vibe $45 + GST per dayHIRE DETAILSPlease provide the following information:Job SiteServiceStart DateStart timeReturn DateReturn timeADDITIONAL DETAILS:Please note the below items: Pick up / Return Address: 18 Durham Place, Glenview 4553 , Australia Security Deposit: Due immediately at the time of booking FEES: Hire Rate: As set out above in ‘Equipment’, subject to whether the Hire is a ‘Short Term Hire’ or ‘Long Term Hire’ If Short Term Hire, the Fees must be paid on or prior to the Start Date. If Long Term Hire, the Fees will be paid within 7 days of receiving an invoice from Empire Solutions. ADDITIONAL CHARGES: Excess Use Charge: $ per hour of Equipment use over 12 hours per day from 6:00am to 5:30pm, calculated over the Hire Term. Excess Travel: 0.30 per km travelled over 200km per day hire Fuel Refill Rate: $3 per Litre Cleaning Fee: $65 Cancellation Fee: $100 if less that 24 hours notice is given or rebooking of hire SECURITY DEPOSIT PAYMENT:Security DepositAmount: $100.00QuantitySecurity DepositPrice: $150.00QuantitySecurity DepositAmount: $50.00QuantityPayment Method Offline Payment Pay with Square I have read and agree to the Terms and Conditions Signature Sign Here Submit Form
