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COASTAL MEDICAL EQUIPMENT ELECTRIC WHEELCHAIR RENTAL AGREEMENT

TERMS & CONDITIONS

EQUIPMENT DAMAGE. Customer is liable for all damage to the equipment except normal wear such as minor scratches and scuffs, unless Customer purchases the additional Rental Equipment Insurance. By agreeing to the Rental Equipment Damage Waiver, renter will not be personally liable for damage to the Equipment up to $400.00. This includes cracks in the plastic body, damaged wheels or steering column. I understand that I will be held personally responsible for all damage to the Equipment other than normal wear.

LOSS OR THEFT. Customer is responsible for the MSRP value of the equipment if lost or stolen.

POSSESSION. Customer will not give or transfer possession of the equipment to anyone else and the equipment shall not be transported out of the State of Mississippi, without express written consent from Coastal Medical Equipment LLC. The equipment shall be returned to Rental Location unless arrangements have been made directly with Coastal Medical Equipment LLC to be dropped off and picked up.

LATE FEE. If Electric Wheelchair is NOT returned by designated date AND time an additional fee will automatically be incurred. A late charge of $10.00 per day will be assessed. If the Electric Wheelchair is not returned within 30 days of the Rental End Date, then Coastal Medical Equipment LLC., will be entitled to the full MSRP value of the Electric Wheelchair as liquidated damages. In relation to the loss of the Electric Wheelchair, this will be Coastal Medical Equipment LLC sole remedy at law and in equity.

Terms Agreement Continuation. Per these term agreements in future Electric Wheelchair Rentals this signature will apply.

Care of Equipment. Equipment can only be used in a careful and proper manner and shall not be used in any way that is inconsistent with Owner’s manuals or instructions.

Repair and Alterations. The costs of all repairs made during the Term shall be paid by Renter, including but not limited to labor, material, parts and other items. Equipment shall not be serviced or repaired and parts and accessories shall not be replaced without Owner’s prior consent.

LIABILITY. Customer expressly assumes all liability arising out of operation of the equipment. Customer agrees to indemnify and hold harmless Coastal Medical Equipment from any and all liability resulting from customer’s acts or omissions including, but not limited to, claims and/or lawsuits for personal injury, property damage, legal fees, costs, lawsuits, claims and judgments that may arise from customer’s use of equipment.

Termination. This Agreement shall terminate on the date specified. Owner reserves the right to terminate this Agreement earlier upon notice to Renter.

ASSUMPTION OF RISK. YOU UNDERSTAND THAT THERE ARE POSSIBLE RISKS TO YOURSELF AND OTHERS, INCLUDING THE RISKS OF DEATH, SERIOUS BODILY INJURY, AND PROPERTY DAMAGE THAT MAY BE ASSOCIATED WITH OPERATING A ELECTRIC WHEELCHAIR. YOU ARE RESPONSIBLE FOR THE SAFETY OF YOURSELF AND ANY GUESTS YOU MAY HAVE ON THE ELECTRIC WHEELCHAIR. YOU HEREBY STATE, THAT TO THE BEST OF YOUR KNOWLEDGE, YOU ARE IN GOOD PHYSICAL AND MENTAL CONDITION, AND UNDERSTAND THE ELECTRIC WHEELCHAIR SAFETY PROCEDURES. YOU VOLUNTARILY ASSUME ALL RISK OF ACCIDENT OR DAMAGE TO YOUR PERSON OR PROPERTY WHICH MAY BE INCURRED FROM OR BE CONNECTED IN ANY MANNER WITH YOUR USE, OPERATION OR RENTAL OF THE ELECTRIC WHEELCHAIR.

RELEASE AND INDEMNIFICATION. YOU HEREBY RELEASE US, OUR OFFICERS, DIRECTORS, EMPLOYEES, REPRESENTATIVES AND AGENTS, FROM ALL CLAIMS, DEMANDS, ACTIONS AND FROM ALL LIABILITY FOR DAMAGE, LOSS OR INJURY (OF WHATEVER KIND, NATURE OR DESCRIPTION) THAT MAY ARISE OUT OF, OR YOU MAY SUSTAIN, IN CONNECTION WITH YOUR USE, OPERATION, OR RENTAL OF THE ELECTRIC WHEELCHAIR. YOU FURTHER AGREE TO INDEMNIFY AND HOLD US HARMLESS, AS WELL AS OUR OFFICERS, DIRECTORS, EMPLOYEES, REPRESENTATIVES AND AGENTS, FROM ALL CLAIMS, DEMANDS, ACTIONS, CAUSES OF ACTION, INCLUDING ATTORNEY’S FEES, EXPENSES AND COSTS, OF YOURSELF OR OF THIRD PARTIES (OF WHATEVER KIND, NATURE OR DESCRIPTION), WHICH MAY ARISE OUT OF, OR IN ANY MANNER CONNECTED WITH, OR CAUSED BY YOUR USE OR BY YOUR GUESTS OR AGENTS, OR OPERATION OR RENTAL OF THE ELECTRIC WHEELCHAIR. THIS RELEASE AND INDEMNIFICATION SHALL BE BINDING UPON YOUR HEIRS, ADMINISTRATORS, EXECUTORS, AND ASSIGNS.

Renter acknowledges this Agreement and acknowledges having read and understood the foregoing.

Thank You for your business

Coastal Medical Equipment
450 East Pass Rd. Ste. 1
Gulfport, MS 39507
228-731-3313

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Signed by Cinda Terrebonne
Signed On: April 4, 2024

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June 29, 2023 2:34 pm CDT

Electric Wheelchair Rental Uploaded by Cinda Terrebonne - [email protected] IP 108.88.241.226