Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What date is the toilet required:

NB: This does NOT guarantee we can deliver on this day; we will contact you to confirm the date.

MM

DD

YYYY

Declaration *

I understand that the first 4 weeks hire, delivery, collection and vat are to be paid in advance

I/We agree and understand that the next period payment must be made on or before the initial payment expires.

I/We understand that if the next payment is not paid the toilet may be removed from site without notice.

I/We understand that any queries must be reported to the accounts office no later than the 15th day of the following month.

I/we agree that collection of the toilet at the end of the hire must be arranged by telephone.

I/We agree to abide by Taplin Plant Hire’s Terms & Conditions (CPA Model Conditions) (Copies are enclosed or are available on request

I/We agree to insure the equipment hired for Damage, Fire and Theft or agree that in the event of Damage, Fire or Theft, I/We understand that we will be responsible for the associated costs incurred and that replacement value will be charged for those items lost, stolen or damaged beyond repair