Hire Agreement FormCUSTOMER DETAILSPlease provide the below detailsNameAddressPhone EmailABNDrivers Licence NumberImage of Drivers Licence FrontChoose File Image of Drivers Licence BackChoose File HIRER DETAILSName: A&D Hire Investment Trust Pty Ltd ABN 36 965 972 798 (A&D Hire Solutions)Address: 18 Durham Place, Glenview 4553 , AustraliaContact Email: empiresolutionscoptyltd@gmail.com VEHICLE HIREPlease select the van you would like to hire: RENAULT Master LWB Hi Roof ($180 per day) IVECO 35c 18v LWB Hi Roof ($200 per day) VW Sprinter LWB Hi Roof ($200 per day) TOYOTA Hiace ($200 per day) ISUZU Pantech 45-150 Truck ($220 per day) OtherFirst 100km included, then .70c per km over the 100kmFirst 100km included, then .75c per km over the 100kmHIRE 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 A&D Hire 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. 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:To be paid by Direct Bank Transfer. Details will be provided after form submission.Security DepositAmount $500.00 I have read and agree to the Terms and Conditions Signature Sign Here Submit Form