EFTA01719835.pdf

,..~n..c- ..~.~~nz.=:-t;:,~>;w ,. -.ti.•arc.~.~~.. ,;w.:,...:._..,..Gv.+ra ..~.::~-..--..a~a.:n...,w .~ t s.:'..c.~.n~:~; :n~ EFTA01719835  Town of Pal int Beach Police Dep at -Meat EVIDE RsiCE CASE #_(:)..S3k _ ma r nay .a.-nal CONTE. t4TS Officer: KL- 231 EFTA01719836  PERMITTED BY lila. WE 00 NOT PROVIDE • UNINSURED- OR • UNDERINSURED MOTORIST PROTECTION, PHYSICAL DAMAGE Rene also refers to arty additional AbilToi.Jed Dna: All Autnow PROTECTION FOR THE THE VEHICLE. "NO FAULT- OR OTHER are font?, and severalty N30;2104 the oh-gatiols under the Agret nit OPTIONAL PROTECTION IN CONNECTION WITH THIS RENTAL AND YOU AND WE HEREBY REJECT. TO THE EXTENT PERMITTED BY LAW. 1. AUTHORIZED DRIVERS. INCLUSION OF ANY SUCH PROTECTION •••• • The Vehicle may be driven only by an TAii•honivid Driver An Authorized Omer :s You and any addtonai •no nonsTienl such protection Shallbe caromed in an amount equal TO the time of renal and signs this Agreement. AT A • • - ihte satisfy our age requirements have a vat minanurn statutory hnancial reams/bitty liability limits of The slate in till cur otneer qualifications No Other persons a'c 3i:on:idea to whth this Agreement is executed. We can von* such protection rue iewo under a certificate 01 self-insurance an insurance policy. and'or an We hope you don't but indemmlicabort as we choOSe 2. THE VEHICLE. If You Have An Accident: 11. OPTIONAL SUPPLEMENTAL LIABILITY INSURANCE ("SU"). W y:r xceptavailaNe ne ani)dnal forsi ani ar therth3bn eaglinn dad ing y cf,ialrenta rge. yYou cv wi signit7el pf tha ot l. vided with protection against Third-Party Claims as outlined below: Immediately report it to Thrifty and the Police. Failure to do !ion with no appre ' • I You will be protected against Third-Party Clams excluding WAN so may void any protection afforded to you under the Rental Family Members as defined in wechon to. other than to the vehicle. WARRANTIES OT V . "the m use omo or m opere appindi cabis of fith neanc Vell ialnres in ern. le.pons Agreement. FOR ANY PARTICu.Az • am acts tiongsalbsrninfy LIAEiLE TO YOU FOR :J.( be liability limits required fly laws in the jurisdiction in which the DAMAGES RELATED DIRE:: - Vehicle rs rented. which Shall De Wetted to as 'Primary Protection" USE THIS FORM to record on-the-scene information. US OF THIS AGREEMENT We can pronde Primary Protection under a certificate of self -insurafte, an insurance policy andior an indemnification as we choose; and. Telephone information to the Thrifty location where you 3 PROHIBITED USES OF THE VEHICLE. 2 SLI proves You with coverage under a separate insurance potcy rented the vehicle immediately. See Rental Agreement for A. The VenicN ma, no: oe used (I) BY OTHER THAN AN AUTHO- providing 'ions insurance against Third-Party Cleans arising out ol RIZED DRIVER: (2) TO PUSH OR TOW ANYTHING. CARRY PERSONS the use or coerabon of the Vehicle for the drIference between the phone number. Then give this form to Thrifty upon return of OR PROPERTY FOR HIRE. IN A RACE, TEST. CONTEST. OR FOR Primary Protection and a rrtaximum too combined single limit of TRAINING ACTIVITY, (3) FOR ANY ILLEGAL PURPOSES. OR IN THE SI.030.000 IU S Der occurrence for iniury. death and property vehicle: or mail. COMMISSION OF A CRIME: (4) WHILE UNDER THE INFLUENCE OF damage to ocher than the Vehicle while rre Vet Ce is on rent TO You ALCOHOL OR DRUGS: IS) TO INTENTIONALLY CAUSE DAMAGE. OR 3. THE EXCESS SLI POLICY EXCLUDES coverage for (a) use of die ENGAGE IN WILLFUL. WANTON OR RECKLESS MISCONDUCT. (71 Vehicle in breach of This Agreement including but not limited to drin Accident: Date Time OUTSIDE OF OUR GEOGRAPHIC DRIVING RESTRICTION OR IN MEXI- lag while ender the Influence of alcohol or drugs in violation of law: Place CO. (8) IF IT WAS OBTAINED BY FRAUD OR MISREPRESENTATION. (b) me by anaidtiorited drivers: (b) claims by Family Members (as defined In SKIOn 10): and (c) the other specific exclusions summa- B. FOR PURPOSES OF THIS AGREEMENT. WILLFUL, WANTON OR rized on The separate brochure available al the counter which is RECKLESS MISCONDUCT INCLUDES. BUT IS NOT LIMITED TO: (1) incorporated herein, receipt of which You hereby acknowledge The Damage To Other Vehicle(s): THE UNAUTHORIZED USE OF THE VEHICLE ON OTHER THAN REGU- SU polity dots not provide coverage for physical damage to the Owner,Address & Phone__ LARLY MAINTAINED HARD SURFACE ROADWAYS. PRIVATE DRIVE- weileht no faury. Tull-party benefits. uninsured or underinsured WAYS OR PARKING LOTS. WHICH UNAUTHORIZED USE DIRECTLY motorist benefits or any other optional protection unless required by RESULTS IN DAMAGE OR LOSS TO THE VEHICLE: (2) USE OF UNAU- taw. To the extent permitted by law, You and we relect the inclusion THORIZED EQUIPMENT ON OR IN THE VEHICLE: (3) AIDING IN THE of any such coverage. If You Purchase SLI. You agree to defend, THEFT Of THE VEHICLE OR FAILING TO SAFEGUARD THE KEYS AND indemnity, and hold us harmless from and against any and all loss, Make & year THE VEHICLE AND IT IS STOLEN OR VANDALIZED: (dl CARRYING PAS- liability or damage whatsoever not paid or covered by SLI or the SENGERS IN THE BED OR CARGO AREA OF THE VEHICLE; (5) A CITA- Pnnury Protection. Driver, Address & Phone TION FOR A SERIOUS TRAFFIC VIOLATION AS DEFINED UNDER STATE LAW. OR i6i FAILURE TO USE SEAT BELTS AND CHILD RESTRAINT 12. HANDLING ACCIDENTS AND OTHER OCCURRENCES. SEATS WHERE REQUIRED OR CARRYING PASSENGERS IN EXCESS OF A. You agree to immediate& file and report any aCcident theft or van. THE NUMBER OF SEAT BELTS IN THE VEHICLE. dalTsm involving the Vehicle to us and to the pcke and Complete an accident report. YOUR FAILURE TO COOPERATE WITH US IN MY Insurance Co. INVESTIGATION OR TO FILE A TIMELY MO ACCURATE REPORT CRE- C ANY PROHIBITED USE OF THE VEHICLE IS A MATERIAL BREACH ATES A REBUTABLE PRESUMPTION THAT THE INCIDENT WAS OF THIS AGREEMENT AND WILL VOID OR DEPRIVE YOU OF ALL BEN- CAUSED BY YOUR WILLFUL. WANTON OR RECKLESS MISCONDUCT EFITS. PROTECTION AND OPTIONAL COVERAGES. IF ANY. TO WHICH Occupants: Indicate vehicle: Yours-#1, other-#2. YOU WOULD HAVE OTHERWISE BEEN ENTITLED TO UNDER THIS AND. ASA RESULT. MAY %too THE OPTIONAL PRODUCTS AND MAKE YOU ABSOLUTELY LAE: c FOR ANY LOSS OR DAMAGE TO THE VEHI- AGREEMENT AND MAKES YOU RESPONSIBLE FOR ALL LOSS OF OR CLE (Circle name if possible injury.) DAMAGE 10 THE VEHICLE. THIRD PARTY CLAIMS, FINES, PENAL- B. You will deliver to m a legit* COPY Of any service of prOCeSS. Plead' TIES. ATTORNEY FEES AND COSTS. mg, or notice of any lend relating to a Claim or suit in connection with Name Address & Phone Vehicle # any acoderi r reason:riot:mg the Vehicle. 4 YOUR RESPONSIBILITY FOR DAMAGE OR LOSS. YOU ARE C. We riser,, riser,,the right to reline to Wwitar0010/01010 to ABSOLUTELY LIABLE FOR ANY LOSS OF OR DAMAGE TO THE VEHI- an for arty CLE, EVEN IF SOMEONE E CAUSED IT OR THE CAUSE IS UNKNOWN WHETHER DUE TO THEFT, FIRE. HAIL, FLOOD, COLLI- SION, VANDALISM OR ANY OTHER CAUSE, SUBJECT TO LIMITA- TIONS IMPOSED BY THE LAW OF THE JURISDICTION WHERE THE 13. lYceeirEnzNilERAL YNhan PROVISIONS. break:lawn. "ate tee bee Sr VEHICLE IS RENTED. YOU IABILITY WILL NOT EXCEED A Vehicle means the vehicle rented or its replacements and all of its VMUE OF THE VEHICLE PLUS ACTUAL TOWING AND STORAGE Parts. equoment accessories. keys and documents CHARGES. LOSS OF OE AND DIMINUTION IN VALUE {WHICH IS THE B No term 01 this Agreement may be waived or changed except by a DIFFERENCE BETWEEN THE VALUE OF THE VEHICLE BEFORE THE Witnesses: Name Address & Phone DAMAGE AND THE VALUE OF THE VEHICLE AFTER THE DAMAGE. Written agreement signed by our authorized repicsentatne. If any term OENT IF NOT RETURNABLE CKE7 LATER, PLUS ANY OUT OF P SS OF R A RESULT OF THE L RMIVE r REGARDLESS OF WHETHER THE VEHICLE IS REPMRED OR NOT). THE DAMAGE DATE YOU REPORT THE INCI. ALL RENTAL CHARGES THROUGH THERETURN EXPENSES TO DATE WHICHEVER IS INCURRED BY US AS THE VEHICLE. A REA- of Res Agreement is prohibited by law, it slut not affect the remaining C Paragraph heachigs have no independent meantg tOhs . You A0,ureeltc that it is Your resper,,,,, to comply with all atiPli- Your name SONABLE ADMINIS FEE AND PRO.RATA LICENSE PLATE PERSONAL INSURANCE r You e Serney l benhotansud Ne thase ild res thetraVineh t lPa tte ° , nor may You transfer or assign FEES ALL AS ALLOWED BY LAW. YOUR LOSS. YOU SHOULD CHECK WITH Your address MAY 'OR MAY NOT COVER ANY YOU MAKE UNAUTHORIZED F0.0rwert ie reserve the right to deny future rental to You if You violate INS YOUR OWN INSURANCE CARRIER. IF TO PAY ANY COST TO REPAIRS VEHICLE, Police: Name Badge! RESTORE THE VEHICLE TO THE CONDITION ANY RENTAL. YOU AGREE TO PAY US OF THE VEHICLE AT THE AMOUNT NOT COY - TIME OF EFTA01719837  ADDENDUM TO TERMS NOTICE TO FLORIDA RENTERS Renter's insurance primary: The valid and col- lectible liability insurance and personal injury pro- Just what you want. tection insurance of any authorised rental or leasing driver is primary for the limits of liability and per- sonal injury coverage required by ss.324.021 7) and lust Thrifty. 627.736, Florida Statutes. Discover why savvy travelers think Thrifty Failure to return rental Vehicle: Failure to return is a smarter way to go. rental property or equipment upon expiration of the rental period and failure to pay all amounts due Great cars - Chrysler names you know igraiilir (including costs for damage to the property or equip- ment) are prima facie evidence of intent to defraud, from cars like the sporty Intrepid to the roomy Caravan. 11111 11 Please Complete At Check-in: punishable in accordance with section 812.155. Florida Statutes. Great locations - Over 1,200 locations AK:drRental Mil0J?C worldwide, including over 80 on-air- In These terms supersede any conflicting, terms slated elsewhere. port locations throughout North Gas America. Great service -Thriftys committed to get- Tura In ting travelers on their way fast. Great rates - Our low rates mean you'll always get a great car at a great price. All year long. Thank you for PEACE And Blue Chip Express Rental service, too! choosing Mint OF_MIND. ) W !Live a feature in n Chrysler can we Nye r have to see. It's a driver's air bag and it can halm: r traction of a iecond to save your life. Thrifty. We take safety t seriously as savings. Call for mailability and ruten-ations today! fl And visit us at riesayagr raw For trocldwitle n-senrations contact your With Blue Chip, all your rental paper- n • travel consultant or call 1.800:Thrifty' (I.800.8474389) or log onto www.thrifty.com Re Local Service & !nit finntiOn-, work is taken care of beforehand. You lust Call On Your Local Thrifty Center! just jump in our Blue Chip Express line, Customer Service: Email thrifty.com/contacts/ show your drivers license and credit 3 , or Call 800.334.1705 c card, sign your name and go. Returns IN CASE OF ACCIDENT: See instructions Under Flap work just as fast Available at U.S. and Canadian airport locations. TTA05O).L 2X15 nerr-a-cat sworn are 0109,25] eav 13 0'.O5-351 A vsa To sign up for Blue Chip Express service. Call 1.888-400.8877 or visit www.thrifty.com M ty esCarRental EFTA01719838  '!Bråris fin n ArCar Rental NEST PAIN ktACII MENIAL NLC0NI : au 4 l'0MPLt ILU BY. u li HENIEU: I A INItHNAii MENIAL: 09 25 05 1/513 NE i UNN: 09 70 OS 1052 MlitS IN: 014 b (Ni: 04;.; mitts DmlittN: 393 PLAN IN/QUI: SPC ti (1 CLS: IDAR 1 DAYS 25.00 n .00 SUBT0T n..00 IAMBI E TOT n.,10 SAILS TAX It/U.14*D C0NCFIENEC :.n/ LAG AEC ..I/ EL SUNCYIG ; FLATAX . II NET DUE PAYMENTS .:13 PAID BY: VI CREDII CARD A. EFTA01719839  Rental Location VeliMeinfommion Rental Expires On Jt,s, [NUT,- CAR httilla. I 0=-1 • VIG LitiV41 Ta I; TAMPA INT'l AIRPORT ii9SFUN STALL*: B58.3 %tar ISee 08149754 TOPA Ft egt40033607 05 CHRYSLER SEBRD64 977-283-0638 Rate: WALK CI': IDAR 929001 TIRE CUT TIRE IN FUEL LEVEL OUT: FULL e5/28.5 l758 MILEAGE OUT: 6482 Dart RATES** EST DE Car To Be Fetumed To Moe Unless Stated Below 8.00/ els • CUSTOMER DECLINES LLM AV IS FEW' S1BLE FOR LOSS OR DAM* PEP TERN. Ind its 25.0a; ;11; CF TIE RENTAL AGREEMENT. .99/p1 NEST PALM BEACH VW DECLINED Fssiai R Iss5as 2.67 • SLI MNP DECLINED DECLINED FEE .47Day SI RCC 2.13//Day 47 2..03 Pistons' Inlonnation E9P a 7.900% 2.11 **ESTIMATED CARGESsit • PUN BCH 5RD FL 33410 BY IDLW INITIALS YOU ACFNOWJECGE EGYE ACCEPTED DELL' ADP— ARE RESPONSIBLE FOR YOURPARrirr r.YE. IF YOU FAIL TO PAY YOUR 0517 FL 01 7/ - PTIONAL ITEMS: ANY UIPAID TID(ET(S) ADDil DRIVER: Noee Di tic o C' .S FEE Kik • " T a erlilitr • FL SLIME MUDS ' I .03 aI -"E RED DEPOSITS 2541.10041/09/c. • 1 a - te returns is charged right after tae start of new Rental Day. LEE FLORIDA - NOTICE TO RENTERS Renter's insurance primary: The valid and collectible liabiity insurance and personal injury protection insurance of any authorized rental or Leasing driver is primary for the limits of liability and personal injury coverage required by ss.324.021 (7) and 627.736. Florida Statutes. • Failure to return rental Vehicle: Failure to return rental property or equipment upon expiration of the rental period and failure to pay all e• amounts due (including costs for damage to the property or equipment) aro prima facio evidence of intont to defraud, punishable in accor- dance with section 812.155, Florida Statutes. • These terms supersede any conflicting terms stated elsewhere. •I • TheRenu, Tad tow rho c.oroato ey statue below. the unOtetagred le:knewiedges and COMMAS mat awe are *PRY eanzed ea operate inerarni cardinals and no tat bah parsed and semen studio the Loss Damp. Yaws, rilormaton. that Saar on this Rental Sistsment and c • o'retveor vntalisoe ronTHG SIGNED AUTHORIZE THE COMPANY TO PROCESS A CHARGE TO THEIR CREW. cEsr OP CHARGE CARD IN THE AMOUNT SPE( ioNAL CHARGES DUE UPON RETUPN Of THE VEHICLE AU. CHARGES SUBJECT TO AUDIT. No sclegeleael drivers en pormelew. *Pi Compact,' X RENTER X AD • liana& arat itaa a • a AM EFTA01719840 Cheek DTG Operations, Inc. In 115 U4 2b kiL . , i S. i 'Owning City RA. a 1 I 1 t it /\ /Side :e thsn. 7 MokeiModel A/C CcW 8.4 2 Di 4 Dr S/W Van Mileage Out Cos Our E I/8 I/4 1/8 I/2 A/8 W4 7/3 ,.6- .2 I I I I i I I/ ) Car In space ND. Dose Out Mork damaged port wth the opp•opriate letter cn drawings. D . Dent S - Scratch 6 . Broken M - Missing C - Cracked Dnver's Side front Recr Passenger's Side Vehicle sebiect to further inspection hr hidden damcge. All new carnage, must be reacted within 24 hrs. Customer Signature and Date Guard Initials C r Cote. I. 15 - is 1 or-sam EFTA01719841