Rental agreement. The _________ Corporation Automobile Rental Agreement No. _________ License No. of Vehicle _________ Driver's license No. _________ State _________ Expiration date _________ Automobile make _________ Body style _________ Rental by _________(employee or agent of lessor) at _________(place) to _________ of _________ (residence and post-office address). Date of rental _________; to be returned _________[Date] at _________(hour) at _________ (place). Time out _________ —.m., _________[Date], Time in _________ —.m., _________[Date] Mileage in _________ Mileage out _________ Miles driven _________ Account Deposit $....................................................................................................... Rental charges _________ miles at _________ per mile $.................................................................................................... _________ hours at _________ per hour ...................................................................................................... _________ days at _________ per day ...................................................................................................... _________ weeks at _________ per week ...................................................................................................... Total rental charges ...................................................................................................... Damage ...................................................................................................... Collision protection ...................................................................................................... Total charges ...................................................................................................... Refund gas ......................................................................................................... Refund repairs ......................................................................................................... Net amount due ......................................................................................................... Computed by _________ Terms and Conditions In consideration of the covenants contained here, the lessor corporation, referred to as lessor, leases to the undersigned renter, upon the terms, covenants and conditions set out here, the motor vehicle described above, referred to as vehicle. (1). Renter acknowledges that the vehicle is the property of lessor and that he or she has received it in good mechanical condition. (2). Renter agrees that he or she will return the vehicle to lessor station from which it was rented, in the same condition as he or she received it, ordinary wear and tear excepted, on the return date stated above or sooner upon demand of lessor. (3). Renter agrees not to use the vehicle for the transportation of persons or property for hire, express or implied; not to use it in violation of any federal, state or municipal law, ordinance, rule or regulation governing the use or return of it; nor to remove it from this state without the written consent of lessor. (4). Renter being one of the assured under the insurance policy covering the vehicle agrees to comply with all the terms and conditions of the policy, which by reference are incorporated here and made a part of this agreement, and to comply with the terms and conditions appearing on reverse side of this agreement. (5). Renter further expressly agrees to indemnify the insurance company for any and all loss, damage, cost and expense paid or incurred by the insurance company because of injuries or damages sustained by occupants of the vehicle, in states where the law makes lessor or its insurance carrier liable for injuries to occupants of the vehicles or because of injuries or damages resulting from the operation of the vehicle in violation of any of the terms and conditions appearing on the reverse side of this agreement. (6). Renter expressly agrees to pay lessor on demand: (a). A mileage charge computed at the rate specified in the current lessor rate schedule for the mileage covered by the vehicle during the period of this rental. (b). Service and time charges computed at the rate specified in the current lessor rate schedule for the period of this rental. (c). A sum equal to the cost of all damages to the vehicle during this rental period provided, however, that renter's liability shall be limited to $_____ unless vehicle was operated in violation of any of the provisions of this rental agreement. (d). A sum equal to the value of all tires, tools and accessories lost or stolen from the vehicle. (7). It is expressly agreed that renter is not the agent, servant or employee of lessor in any manner whatsoever. Collision Protection If [this paragraph] has been initialed on behalf of _________, then for an additional fee of _________ per day (with a maximum of _________ per week), _________ agrees to relieve renter of all liability for collision damage to the _________ vehicle referred to above while it is operated in conformity with this rental agreement, but renter shall be fully liable for all such damage if the vehicle is operated in violation of any law or this rental agreement. Signed renter _________ Local address _________ Tel. No. _________ Charge and mail invoice to: Print name _________ Street _________ City and state _________ Important: Show name and address exactly as should appear on account records. ------fn ------