Name             Company

Phone                      Fax

Address            Contact

City/State             P.O.#

Postal Code          Date

APPLICATION:

 Job to be performed with equipment

For use at, and not to be removed from without Lessor’s consent

Please deliver the equipment to our location

City         State Choose a State: Albama Alaska Arizona Arkansas California Colorado Connecticut Delware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Mayland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York New Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other   

Customer will pick-up from FOB location please call for nearest location

Unit required

Flow Pressure Style Trailer Skid

Accessories required:

Demo/Training required 

     Duration of requirement 

Operator required

     Duration of requirement 

Date of delivery   

Time of delivery   

Date of return       

Time of return       

TERMS AND CONDITIONS

It is understood that rental charges begin with date and hour of this lease and continue without interruption until the above described equipment is returned to Lessor’s plant, unless otherwise specified in writing, leasee agrees to defend Lessor from and to indemnify and leave Lessor safe and harmless from any and all claims that may arise from or by virtue of Lessee’s use or handling of the above equipment to lessor’s plant in as good condition as it was received by Leasee, normal wear and tear expected, and to pay lessor for any and all damages to said equipment during the rental period.  Leasee grants Lessor the right to enter upon any location to inspect this equipment and to remove said equipment when in lessor’s opinion, said equipment is being worked beyond its intended capacity or abused in any way whatsoever.  Lessee agrees that Lessor retains complete title to this equipment and that nothing in this Lease or elsewhere, either expressed or implied, gives Lessee any claim of ownership.  No repairs or alterations are to be made on above equipment without the written permission of the Lessor, and the cost of such repairs and alterations shall be paid by the Leasee.

Hydro-Engineering, Inc.

REQUIREMENTS:   Reponse to rental quote will only be an estimate, actual charges will be calculated upon return of equipment when actual time, parts usage, and damages can be determined.  Invoice will itemize all additional charges.

Lessor:     Hydro-Engineering, Inc.           Leasee:   

By:           Darrell R. Saha-President                 By: