Allam Motor Services Courtesy Car Agreement

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					                                Allam Motor Services Courtesy Car Agreement

         Vehicle Details –   To be completed by service advisor

Vehicle / Model………………………………………Registration Number……………………………………………….

Date of loan………./………./…………                          Mileage at time of loan…………………………………………….

Time………………..                                        Defect/damage……………………………………………………..

Date of return…………/………/……..                          Mileage on return…………………………………

         Insurance Details
Please tick the appropriate box for your insurance arrangements
 I confirm I will make my own arrangements to insure the above vehicle. I also confirm that these
      arrangements will contain fully comprehensive cover and I understand I will be responsible for whatever
      excess is applicable.
 I Instruct Allam Motor Services to arrange insurance and understand that I we shall be liable for the first
      £500 of any insurance claim
 I instruct Allam Motor Services to arrange insurance. I agree to pay a £10.00 excess waiver and will
     therefore not be liable for any insurance excess.
           I agree to pay £10.00 Now                Please add £10.00 to my invoice

         Customer Details

Full Name……………………………………………………………………………………………….…………………………………………………..

Address……………………………………………………………………………………………………………………………………………………….

…………………………………………………….Postcode………………………………………………………………………………….

Home Tel…………………………………………Mob Tel……………………………………………………………………

WorkTel…………………………………………...Email……………………………………………….…………………….

Drivers Licence No…………………………………………………….Expiry Due……../……../…….

Have you had any driving convictions in last 5 years -               Yes         No

If Yes, please list details…………………………………………………………………………………………………

        Terms & Conditions
    1) This vehicle must not be used by anyone other than the person named above.
    2) The customer named above will be liable for any penalty offences, excess parking, congestion
       charges or any other penalty incurred whilst the vehicle is in their possession. Please be aware
       any penalty charges will incur a £25.00 administration fee.
    3) Fuel is not included in any loan agreement. We ask you to fill up with the fuel you require and/or
       replace any fuel you used. Any fuel not replaced will be charged
    4) You must be over the age of 21 and under the age of 75 ( or using customers own insurance)
    5) You will be liable for any costs that are incurred to return the vehicle to its original condition at
       the commencement of the loan.
    6) We operate a NO SMOKING POLICY which includes all of our vehicles; please do not smoke in
       this vehicle.
    7) No pets or animals are allowed in our vehicles due to dirt and damage
    8) Alloy wheel kerbing, is vehicle damage, and you will occur a charge of £50 per damaged wheel
       (£10.00 excess vehicle will cover this)

         Agreement

In respect of the above courtesy car agreement, I agree to the terms and conditions as stated above and will
ensure I reimburse any fuel used returning the vehicle.

Signed………………………………………….Print……………………………………..Date……./……./……..

				
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posted:6/2/2011
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