Twin Cities Chapter Equipment Rental Form - American Red Cross

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					Twin Cities Red Cross Equipment Rental Guide
E-mail: reserve@redcrosstc.org
Fax: 612.872.3272 Mail: 1201 West River Parkway, Minneapolis MN 55454

Contact Name Organization Address City Phone State E-mail Zip Code Org ID

Date 11/7/2009

Payment Method (Choose One): Upon Pick Up Contact Me Invoice (must have Org ID) Reference PO # Rental / Purchase Pick up Date Rental Return Date
* All Rental items must be returned by 4:30 PM

Rental/Purchase Method (Choose One): Pick Up Deliver (one way) Deliver / Retrieve Ship AM / PM AM / PM Delivery Date: Org ID

Delivery/ Shipment fee: Deliver/ Ship to: Address City Item Code 9985 9998 9997 9994 2000 2000 9015 6690 6690 6690 6690 5607

State

Zip Code Est. Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Quantity Item Description Price Rental Items (price per day) $15.00 Adult Manikin Additional day rental $8.00 $15.00 Child Manikin Additional day rental $8.00 $15.00 Infant Manikin Additional day rental $8.00 $2.00 Extra Faces $20.00 AED Trainer, single unit $120.00 AED Trainer, 6 pack $8.00 Babysitter's Training Doll Bag (set of 5) $5.00 DVD FA/CPR/AED Workplace $5.00 DVD FA/ CPR/AED Schools/Comm $5.00 DVD CPR/AED PR $5.00 DVD Babysitter's Training $5.00 VIDEO: Bloodborne Pathogens: PDT Estimated Rental Subtotal

Twin Cities Red Cross Equipment Rental Guide
E-mail: reserve@redcrosstc.org
Fax: 612.872.3272 Contact Name Phone 0 0 E-mail

Pick up Date
0

0

Time

0

656694 652145 652162 656692 656691 656695 321330 655633 655731 100043 100045 100046 151201 329705 329710

5205 5200
Notes:

Participant Materials (price per item) First Aid/CPR/AED Workplace Booklets $2.50 First Aid/CPR/AED Schools/Community Book $15.99 CPR/AED Professional Rescuer Student Manual $12.99 First Aid Skill Card $6.99 Adult CPR/AED Skill Card $7.25 Infant & Child CPR Skill Card $7.25 First Aid and CPR Training Packets $1.59 Babysitter Training Participant Materials $14.95 Lifeguard Training Manual $34.99 Class Items (price per item) Nitrile Glove (100/box) $16.95 4x4 Gauze Pad (200/pkg) $6.50 Roller Gauze (12/pkg) $6.50 Manikin Face Shield (36 per roll) $10.50 Pocket Mask (Hard Case) $11.95 Pocket Mask (Soft Case) $13.95 Other Item Not Listed: Other Item Not Listed: Other Item Not Listed: Delivery Charge Shipping and Handling Estimated Subtotal Tax Estimated Rental Subtotal Additional fees or services Estimated Total Confirmed By

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

$0.00 $0.00 $0.00 $0.00 $0.00

For Twin Cities Red Cross Chapter use only

Date of Pick Up/ Delivery

Customer Signature Equipment Associate Initials Customer Signature Equipment Associate Initials

Date of Return

Twin Cities Red Cross Equipment Rental Guide
E-mail: reserve@redcrosstc.org
Fax: 612.872.3272 Mail: 1201 West River Parkway, Minneapolis MN 55454

We cannot guarantee the availability of equipment and materials with less then 2 weeks notice.

Confirmation Policy
Please contact us at least 3 business days before pick-up to make adjustments to your estimated order

Cancellation Policy
Please allow at least 3 business days notice to cancel an order. Rental orders not cancelled within this time frame may be subject to a $25 restocking fee.

Returning Unused Participant Materials
Unused Participant Materials may be returned for the full purchase price only when accompanied by the original receipt of purchase or proof of invoice. * We retain the right to refuse used or damaged materials for return.

Delivery Charge
Delivery Charge is based on one trip (delivery or pickup) to your location. $25 is the estimated cost, but may be more based on your location. Please contact a Customer Service Associate for a full schedule of delivery fees.

Shipping and Handling
Shipping and Handling is based on Standard UPS Ground rates by weight and distance. We do not ship rental materials UPS Shipping Estimator https://wwwapps.ups.com/ctc/request?loc=en_US

Rental Guide

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