ABC COMPANY RENTALS - Eclaims Line

[Pages:1]ABC COMPANY RENTALS

Pickup Location: PHILA. INTL. AIRPORT 123 Main Street Philadelphia, PA 12345

Dropoff Location: PHILA. INTL. AIRPORT 123 Main Street Philadelphia, PA 12345

Phone Numbers: Toll-Free #(866)123-4567 Roadside #(866)111-2222

RENTER DETAILS Name: JOHN SMITH

UNIT DETAILS

RENTAL #: ABCDE-98765

**ADDITIONAL AUTHORIZED DRIVER(S)** Must be listed on the contract at time of rental and be 21 or older with a valid driver's license. Operation by an unauthorized driver voids any/all coverages.

Vehicle to be assigned upon EXIT. Section: ____________________

Additional Driver: NONE

CHECKED OUT BY: DATE/TIME OUT: DATE/TIME DUE IN: MILEAGE OUT: MILEAGE IN: DATE/TIME IN:

BOB 09/01/2018 10:15 AM 09/14/2018 12:00 PM 50,000 50,102 09/14/2018 11:53 AM

Important Information: ? RATES DO NOT INCLUDE GAS AND ARE BASED ON A MINIMUM RENTAL OF 24 HOURS PLUS MILEAGE ? Renter must immediately report all damage to the lessor and all accidents to both the police and the lessor. Renter must also complete a lessor accident report. ? ABC Company Rentals has waived uninsured/underinsured motorist coverage and same is not available to renter, operator, or passengers.

NOTICE ABOUT YOUR FINANCIAL RESPONSIBILITY You are responsible for all Damage to the vehicle, even if someone caused it or the cause is unknown. You are responsible for the cost of repair up to the value of the vehicle, storage and impound fees. Your own insurance or the issuer of the credit card you use to pay for the rental may cover all or part of your financial responsibility for damage to, or loss of, the rented vehicle.

Please ensure your document includes the highlighted

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________ By initialing here I agree to purchase each of the above coverages and that I declined any other coverages I have been offered.

I certify that I did not exit the Airport on ABC Company Rentals shuttle bus and/or I did not use an Airport courtesy phone to arrange the car rental within 24 hours of arrival at the aiport.

_____________________________________________________ Signature

* LOSS OF USE - The renter is responsible for the daily rate on the contract for each and every day the vehicle is unavailable to rent while it is being repaired, regardless of ABC Company's fleet utilization. * ADMINISTRATIVE FEE - The renter is responsible for an Administrative or Processing Fee equa to a 10% of the damages, with a maximum of $500.00.

DEPOSIT MILES FREE: **CHARGE SUMMARY**

Miles Unlimitied

$300.00 UNLIMITED MILES

Fuel

@ $0.00/Gal.

PHL Concess 11.1@ 11.10%

PA Tax PHL 9.5%@ 9.50%

PA Rental Tx 7.7%@ 7.70%

$22.71 $20.97 $16.99

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RENTER PAYMENTS: NET DUE FROM RENTER:

$300.00 -$60.67

Acknowledge X: _____________________________

I understand I am responsible for payment of all tolls, fines, and violations and hereby authorize ABC Company Rentals to release my rental card charge/debit card and personal information to Violation Management Services (VMS) and/or Highway Toll Administration, LLC for the exclusive purpose of processing and billing for parking or traffic fines, penalties, and/or toll charges plus a service fee up to $40 for each infraction or toll incurred during the term of this rental. I have read the terms and conditions of all pages on this agreement and agree thereto and also to return vehicle to lessor or his agent on or before due back date and at a place specified. The rate is only guaranteed for the original duration of the rental as stated in the rental agreement. All charges subject to Final Audit.

x ________________________________________ Renter's Signature

x ________________________________________ Additional Renter's Signature

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