HomeMy WebLinkAbout20171274.tiffBOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
RE: ((We ofdoamrnl /issue to be detvese) Equipment leave with 4 Riven Equipment
DEPARTMENT: Public Works DATE: 4/24/2017
PERSON REQUESTING: Jerry Joseph
Brief description of the problem/issue:
The mining division is in need of a 40 ton articulated haul truck to move material at the Pierce, Peters and Hokestra
Pits. Four quotes were received the lowest monthly cost was from 4 Rivers Equipment for $9,500/month based
on 200 hours/month for a total of $66,500 for seven months. There was $69,000 approved in the 2017 budget for
this lease based on the previous lease of $11,500/month.
What options exist for the Board? (Include consequences, impacts, costs, etc. of options)
A) The board can approve the month to month contract.
B) The board can deny the month to month contract.
Recommendation:
The Public Works Department recommends option A.
Sean P. Conway
Julie A. Cozad, Chair
Mike Freeman
Barbara Kirkmeyer
Steve Moreno, Pro -Tern
(-'7
Approve
Schedule
Recommendation Work Session
Other/Comments;
ec•c}x&.e- (P14)
2017-1274
EQUIPMENT RENTAL AGREEMENT
FOR OFFICE USE
CONTRACT NUMBER
131143
LESSEE NAME
WELD COUNTY
CUSTOMER NO
10905
STREET ADDRESS
1111 HILL STREET
DATE
4/21/2017
GOVT BID NUMBER
DEA! FR ACCOUNT NUMBER
7478
CITY STATE ZIP CODE
GREELEY CO 80831
LESSOR NAME & ADDRESS FORT COLLINS-4 RIVERS EQUIPMENT
125 JOHN DEERE DR
FORT COLONS CO 80524
9704827154
TELEPHONE
970-3584000
NAME OF CONTACT
JERRYJOSEPH
PHONES
PURCHASE ORDER NO
TBD
PURCHASER TYPE:
MARKET USE
EQUIPMENT WILL (County) (City) (State)
BE USED AT WELD GREELEY CO
COUNTY CODE
CO123
RerMafsarBrayableInAdVance ofUsaof quipment
RENTAL TERM
Begin Date: 4/24/2917
End Date: 5/21/2017
RENTAL IS:
$9,500.00
Hour Day Week 4 Week
Per D 0 0
MINIMUM RENTAL
GUARANTEED BY LESSEE
$0.00
ADDITIONAL CHARGES (Specify)
$0.00
2% SMM or 2% DRACSMAA
Rental Unit Make
Model
DESCRIPTION OF RENTAL EQUIPMENT`
Model Name Eq ID PIN No
EL TG
92377
Contract Notes
S/N: 1 DW410ETJEE859863
MODEL YEAR: 2014
RENTAL RATE BASED ON 200HRAlAONTH USAGE
START DATE SUBJECT TO CHANGE
John Deere 410E
869883
Meter Reading Present Value
IDW410ETJEE6598 3124
$362500.00
Total Present Value 5'+42,500.00
Lessor hereby leases to lessee the equipment identified above ("Equipment" for the teen and with the rental payments set out above. Rental payments shall be made to Lessor at the
address shown above, subject to the provisions of paragraph 4 on the reverse side hereof. The Equipment will be transported to and from Lessors place of business during the rental
term at Lessee's expense. Lessee also agrees to pay any additional charges noted above upon or before receiving the Equipment from the Lessor.
his contemplated that the Equipment will be operated for not more than:
NO. OF HOURS IN ANY ONE DAY
8
NO. OF HOURS IN ANY ONE WEEK
40
NO. OF HOURS IN ANY 4 WEEKS
160
Lessee agrees to pay additional rental prorated at the applicable daily, weekly or 4 week rate for each hour the Equipment is used in excess of such time. The additional rent for excess
hours of use will be paid at the time the Equipment is returned or, if the Equipment la leased for more than thirty days, on the first day of the month following such use. If an hour meter Is
furnished, (1) Lessee agrees to keep it connected to the Equipment and in good working condition at all times, and (2) It vnll be used as the conclusive measure tithe number of hours
of operation.
if Lessee fails to return the Equipment by the end of the rental term, Lessee will pay additional rental, prorated at one and one-half times the normal rental, for each day that the
Equipment remains unretumed.
Lessee assumes all risks and liability for and agrees to told Lessor and Its assign harmless from all personal injuries and death, property damage, suts, claims (including third party
claimms),loso>,expenses, rte, and attorney fees, arising from or in connection with the Lessee's use, possession, enbusbnent to others, or transportation of the Equipment Lessee.
at Lessee's expense, will tarty general liability insurance with limits of liability not less than $1,000,000 per occurrence and $1,000,000 aggregate, unless greater liability Amite are
specified below.
PER OCCURRENCE LIMIT PER AGGREGATE OMIT
I $0.00
$0.00
Lessee agrees to furnish a certificate of insurance to Lessors satisfaction evidencing Lessee's compliance with the foregoing requirement and name tie Lessor as an additional insured
on the Lessee's general liability policy upon demand by Lessor.
ORIGINAL
02O/ 7, /02 7 4
Lessee shall indemnity Lessor against all loss or damage to the Equipment while it is out of Lessors possession. The amount of any such loss or damage will be based on the
value shown above. Damage to the Equipment, other than a total loss. will not abate or excuse the making of presorted rental payments. Lessee agrees to use and care for the
Equipment in a careful and prudent manner.
Lessee agrees to pay all operating and maintenance expenses while the Equipment is out of the Lessors possession, and to make or secure any needed repairs. All repairs shall
be at Lessee's expense, except to the extent that Lessor performs repairs and obtains compensation for doing so from the manufacturer. To the extent permitted by law, neither
Lessor, its assigns, the wholesale distributor or manufacturer makes any representation or promise as to the quality, performance or freedom from defect of the Equipment, and
NO IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS IS MADE Neither Lessor, its assigns, the wholesale dreotbutor or manufacturer will be liable for any Incidental
or consequential damages which may result from the use, performance or failure of the Equipment Lessee acknowledges that the Equipment is of a size, design and capacity
selected by Lessee and that Lessee is satisfied that the Equipment is suitable for Lessee's purposes.
Lessee will return the Equipment to Lessor in as good condition as received, reasonable weer end tear excepted, by the end of the rental term. If the Equipment is not in such
good condition upon its return to Lessor and Lessor elects to repair it, Lessee will pay for such repairs at Lessors regular shop rates.
Lessor may, at Lessors option, replace the Equipment with a similar machine at any time during the rental term. Lessor will notify Lessee if Lessor intends to exercise this option,
and Lessee will have three (3) business days following such notice in which to exercise the purchase option provided below or return the Equipment to Lessor. Upon return of the
Equipment to Lessor, the rental tern hereunder shall terminate, and the parties will enter into a new original Rental Agreement covering the replacement machine. Such new
Rental Agreement shall exten& at a minimum, for the remainder of this Rental Agreement's rental term and have a rental rate no greater than the rate for rental of the Equipment
hereunder.
Upon or before the end of the rental term, Lessee may elect to purchase the Equipment for the "Ibtal Present Value" specified on this Rental Agreement, and may apply to
such purchase price' 0 I % of all rentals previously paid. An election to purchase will be evidenced by execution of a purchase order form supplied by Lessor.
THIS RENTAL AGREEMENT IS SUBJECT TO ALL OF/THE TERMS AND CONDITIONS SET OUT BELOW.
LESSEE (Customer) - All new equipment rented hereunder was received with
Operator's Manuals, and operation and servicing have
been explained to me.
SIGNATURE
MAY 082011
Steve Moreno, Pro-Tem
DATE
Board of Weld County Commissioners
LESSOR (Dealer) - The equipment rented hereunder was set up, Inspected and,
if new, adjusted according to factory recommendations
before delivery Operation and servicing have been
explained to the Lessee.
SIGNATURE DATE
RENTAL AGREEMENT
t. Addition of rise
Lessee will not without Lessors written consent, Install any accessories or devices on the Equipment if such installation will impair the originally intended function or use of the
Equipment All accessories or devices affixed to the Equipment will become the property of Lessor unless such accessory or device can be removed without In any way affecting
the originally intended function or use of the Equipment Any damage to the Equipment caused by the removal of such accessories or devices will be repaired at Lessee's
expense.
2. Compliance with Regulations
Lessee will comply with all laws and regulations relating to ownership, possession, use or maintenance of the Equipment
Inspection
Less
ee e l whenever requested, advise Lessor of the exact location of the Equipment. Lessor and its representatives may, for the purpose of inspection, enter upon any job,
building or place where the Equipment Is located at any reasonable time. Lessor may remove the Equipment without notice to Lessee it, in the opinion of the Lessor, it is being
used beyond its capacity or in any other manner improperly cared for orabused.
4. nment
Lessee agrees that Lessor may assign this Rental Agreement and all right, title and interest of Lessor in and to the Equipment, and all sums due or to become due to Lessor
hereunder (of which assignment Lessee hereby waives notice), and Lessee agrees to recognize such assignment Lessee's obligation to pay rent under this Rental Agreement
will not as to any such assignee be subject to any diminution arising out of any breach of any obligation hereunder or other liability of Lessor to Lessee. Lessee may not assign
this Rental Agitation ht
Lessee further agrees to make rental payments directly to John Deere Construction Equipment Company ("Deere'), if Deere becomes Lessors assignee, upon and following
receipt
from Deere of hereunder. dente of assignment end a written request to do so, and Lessor agrees to recognize any payment so made as satisfaction of Lessee's obligation to mane
that payment
8. Default
If Lessee fails to make any rental payment when due, attempts to sell or encumber the Equipment, ceases operating, Institutes or has instituted against It proceedings under a
bankruptcy or insolvency law, makes an assignment for the benefit of creditors or fails to complywith any other provision of this Rental Agreement, or if any attachment, execution,
n
writ or process is levied against the Equipment or any of Lessee's property, or if for any reason Lessor deems itself insecure or the Equipment unsafe, Lessor may terminate the
rental term hereunder by giving Lessee written notice thereof, in which event Lessee will deliver the Equipment to Lessor on demand, and Lessor may enter upon any job, building
or place where the Equipment is located and take possession of it without notice to Lessee. In the event of such termination, Lessee agrees to pay all guaranteed rentals and all
other rentals due, damages for any injury to the Equipment, legal expenses, costs of removal of the Equipment from the possession of Lessee, and all freight storage,
transportation and other charges incurred in such removal and return to Lessor at its place of business.
The parties further agree that Deere, if Deere becomes Lessor's assignee, also may terminate the rents) term hereunder and take possession of the Equipment upon any of the
events specified above, including without limitation Deere's determination that its interest is insecure or the Equipment Is unsafe, regardless of whether Lessor concurs in Deere's
judgment or desires to terminate the rental term. The parties further agree that in the event Deere elects to terminate the rental tens, Lessee shall pay to Deere all rentals due,
damages for any injury to the Equipment, legal expenses, and costs or removal of the Equipment from the possession of Lessee.
6. Construction
This is an agreement for rental only. Nothing herein will be construed as conveying to Lessee any right, tie or interest in or to the Equipment, except as a lessee.
7. Guaranteed Rental - Return of Equipment
Provided the guaranteed rental set ffoodNht on the reverse side is or has been paid, Lessee may return the Equipment and terminate the rental tans hereunder on three days notice to
Lessor.
8. General
Time is of the essence of this Rental agreement Lessors failure at any time to require strict performance by Lessee of any provision of this Rental Agreement wig not waive or
diminish Lessor's right thereafter to demand strict compliance with that or any other provision. Waiver by Lessor of any default will not waive any other default This Rental
Agreement may not be modified except by a written revision signed by the parties hereto. Lessee acknowledges receipt of a signed copy of this Agreement
020/7 /it 747t
EQUIPMENT RENTAL AGREEMENT
FOR OFFICE USE
CONTRACT NUMBER
131353
LESSEE NAME
WELD COUNTY
CUSTOMER NO
10905
STREET ADDRESS
1111 HILL STREET
DATE
5/15/2017
GOVT BID NUMBER
DEALER ACCOUNT NUMBER
7476
CITY STATE ZIP CODE
GREELEY CO 80631
LESSOR NAME & ADDRESS FORT COLLINS-4 RIVERS EQUIPMENT
125 JOHN DEERE DR
FORT COLLINS CO 80524
9704827154
TELEPHONE
970-356-4000
NAME OF CONTACT
JERRY
PHONE #
PURCHASE ORDER NO
JERRY JOSEPH
PURCHASER TYPE:
MARKET USE:
EQUIPMENT WILL (County) (City) (State)
BE USED AT WELD CO
COUNTY CODE
CO123
Rentals are Payable in Advance of Use of Equipment
RENTAL TERM
Begin Date: 5/15/2017
End Date: 6/11/2017
RENTAL IS:
1_ $9,500.00
Per
Hour
Day
Week
4
Week
MINIMUM RENTAL
GUARANTEED
BY LESSEE
I
ADDITIONAL CHARGES
(Specify)
$0.00
✓
$0.00
2% SMM or 2% DRACSMM
DESCRIPTION OF RENTAL EQUIPMENT
Rental Unit Make
Model
Model Name
EgID
PIN No
Meter Reading Present Value
92377
Contract Notes
John Deere 410E
BL TG
659863
1 DW410ETJEE6598 3131
$362500.00
Total Present Value $362,500.00
S/N: 1 DW410ETJEE659863
MODEL YEAR: 2014
RENTAL RATE BASED ON 200HR/MONTH USAGE
Lessor hereby leases to Lessee the equipment identified above ("Equipment") for the term and with the rental payments set out above. Rental payments shall be made to Lessor at the
address shown above, subject to the provisions of paragraph 4 on the reverse side hereof. The Equipment will be transported to and from Lessor's place of business during the rental
term at Lessee's expense. Lessee also agrees to pay any additional charges noted above upon or before receiving the Equipment from the Lessor.
It is contemplated that the Equipment will be operated for not more than:
NO. OF HOURS IN ANY ONE DAY NO. OF HOURS IN ANY ONE WEEK
8 40
NO. OF HOURS IN ANY 4 WEEKS
160
Lessee agrees to pay additional rental prorated at the applicable daily, weekly or 4 week rate for each hour the Equipment is used in excess of such time. The additional rent for excess
hours of use will be paid at the time the Equipment is returned or, if the Equipment is leased for more than thirty days, on the first day of the month following such use. If an hour meter is
furnished, (1) Lessee agrees to keep it connected to the Equipment and in good working condition at all times, and (2) it will be used as the conclusive measure of the number of hours
of operation.
If Lessee fails to return the Equipment by the end of the rental term, Lessee will pay additional rental, prorated at one and one-half times the normal rental, for each day that the
Equipment remains unreturned.
Lessee assumes all risks and liability for and agrees to hold Lessor and its assign harmless from all personal injuries and death, property damage, suits, claims (including third party
claims), losses, expenses, costs, and attorney fees, arising from or in connection with the Lessee's use, possession, entrustment to others, or transportation of the Equipment. Lessee,
at Lessee's own expense, will carry general liability insurance with limits of liability not less than $1,000,000 per occurrence and $1,000,000 aggregate, unless greater liability limits are
specified below.
PER OCCURRENCE LIMIT
$0.00
PER AGGREGATE LIMIT
r $0.00 I
Lessee agrees to furnish a certificate of insurance to Lessor's satisfaction evidencing Lessee's compliance with the foregoing requirement and name the Lessor as an additional insured
on the Lessee's general liability policy upon demand by Lessor.
ORIGINAL
Lessee shall indemnify Lessor against all loss or damage to the Equipment while it is out of Lessor's possession. The amount of any such loss or damage will be based on the
value shown above. Damage to the Equipment, other than a total loss, will not abate or excuse the making of prescribed rental payments. Lessee agrees to use and care for the
Equipment in a careful and prudent manner.
Lessee agrees to pay all operating and maintenance expenses while the Equipment is out of the Lessor's possession, and to make or secure any needed repairs. All repairs shall
be at Lessee's expense, except to the extent that Lessor performs repairs and obtains compensation for doing so from the manufacturer. To the extent permitted by law, neither
Lessor, its assigns, the wholesale distributor or manufacturer makes any representation or promise as to the quality, performance or freedom from defect of the Equipment, and
NO IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS IS MADE. Neither Lessor, its assigns, the wholesale distributor or manufacturer will be liable for any incidental
or consequential damages which may result from the use, performance or failure of the Equipment. Lessee acknowledges that the Equipment is of a size, design and capacity
selected by Lessee and that Lessee is satisfied that the Equipment is suitable for Lessee's purposes.
Lessee will return the Equipment to Lessor in as good condition as received, reasonable wear and tear excepted, by the end of the rental term. If the Equipment is not in such
good condition upon its return to Lessor and Lessor elects to repair it, Lessee will pay for such repairs at Lessor's regular shop rates.
Lessor may, at Lessor's option, replace the Equipment with a similar machine at any time during the rental term. Lessor will notify Lessee if Lessor intends to exercise this option,
and Lessee will have three (3) business days following such notice in which to exercise the purchase option provided below or return the Equipment to Lessor. Upon return of the
Equipment to Lessor, the rental term hereunder shall terminate, and the parties will enter into a new original Rental Agreement covering the replacement machine. Such new
Rental Agreement shall extend, at a minimum, for the remainder of this Rental Agreement's rental term and have a rental rate no greater than the rate for rental of the Equipment
hereunder.
Upon or before the end of the rental term, Lessee may elect to purchase the Equipment for the "Total Present Value" specified on this Rental Agreement, and may apply to
such purchase price I 0 % of all rentals previously paid. An election to purchase will be evidenced by execution of a purchase order form supplied by Lessor.
THIS RENTAL AGREEMENT IS SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET OUT BELOW.
LESSEE (Customer) - All new equipment rented hereunder was received with
Operator's Manuals, and operation and servicing have
been explained to me.
SIGNATURE
DATE
LESSOR (Dealer) - The equipment rented hereunder was set up, inspected and,
if new, adjusted according to factory recommendations
before delivery. Operation and servicing have been
explained to the Lessee.
SIGNATURE
DATE
RENTAL AGREEMENT
1. Addition of Accessories
Lessee will not, without Lessor's written consent, install any accessories or devices on the Equipment if such installation will impair the originally intended function or use of the
Equipment. All accessories or devices affixed to the Equipment will become the property of Lessor unless such accessory or device can be removed without in any way affecting
the originally intended function or use of the Equipment. Any damage to the Equipment caused by the removal of such accessories or devices will be repaired at Lessee's
expense.
2. Compliance with Regulations
Lessee will comply with all laws and regulations relating to ownership, possession, use or maintenance of the Equipment.
3. Inspection
Lessee will, whenever requested, advise Lessor of the exact location of the Equipment. Lessor and its representatives may, for the purpose of inspection, enter upon any job,
building or place where the Equipment is located at any reasonable time. Lessor may remove the Equipment without notice to Lessee if, in the opinion of the Lessor, it is being
used beyond its capacity or in any other manner improperly cared for or abused.
4. Assignment
Lessee agrees that Lessor may assign this Rental Agreement and all right, title and interest of Lessor in and to the Equipment, and all sums due or to become due to Lessor
hereunder (of which assignment Lessee hereby waives notice), and Lessee agrees to recognize such assignment. Lessee's obligation to pay rent under this Rental Agreement
will not as to any such assignee be subject to any diminution arising out of any breach of any obligation hereunder or other liability of Lessor to Lessee. Lessee may not assign
this Rental Agreement.
Lessee further agrees to make rental payments directly to John Deere Construction Equipment Company ("Deere"), if Deere becomes Lessor's assignee, upon and following
receipt from Deere of evidence of assignment and a written request to do so, and Lessor agrees to recognize any payment so made as satisfaction of Lessee's obligation to make
that payment hereunder.
5. Default
If Lessee fails to make any rental payment when due, attempts to sell or encumber the Equipment, ceases operating, institutes or has instituted against it proceedings under any
bankruptcy or insolvency law, makes an assignment for the benefit of creditors or fails to comply with any other provision of this Rental Agreement, or if any attachment, execution,
writ or process is levied against the Equipment or any of Lessee's property, or if for any reason Lessor deems itself insecure or the Equipment unsafe, Lessor may terminate the
rental term hereunder by giving Lessee written notice thereof, in which event Lessee will deliver the Equipment to Lessor on demand, and Lessor may enter upon any job, building
or place where the Equipment is located and take possession of it without notice to Lessee. In the event of such termination, Lessee agrees to pay all guaranteed rentals and all
other rentals due, damages for any injury to the Equipment, legal expenses, costs of removal of the Equipment from the possession of Lessee, and all freight, storage,
transportation and other charges incurred in such removal and return to Lessor at its place of business.
The parties further agree that Deere, if Deere becomes Lessor's assignee, also may terminate the rental term hereunder and take possession of the Equipment upon any of the
events specified above, including without limitation Deere's determination that its interest is insecure or the Equipment is unsafe, regardless of whether Lessor concurs in Deere's
judgment or desires to terminate the rental term. The parties further agree that, in the event Deere elects to terminate the rental term, Lessee shall pay to Deere all rentals due,
damages for any injury to the Equipment, legal expenses, and costs or removal of the Equipment from the possession of Lessee.
6. Construction
This is an agreement for rental only. Nothing herein will be construed as conveying to Lessee any right, title or interest in or to the Equipment, except as a lessee.
7. Guaranteed Rental - Return of Equipment
Provided the guaranteed rental set forth on the reverse side is or has been paid, Lessee may return the Equipment and terminate the rental term hereunder on three days notice to
Lessor.
8. General
Time is of the essence of this Rental agreement. Lessor's failure at any time to require strict performance by Lessee of any provision of this Rental Agreement will not waive or
diminish Lessor's right thereafter to demand strict compliance with that or any other provision. Waiver by Lessor of any default will not waive any other default. This Rental
Agreement may not be modified except by a written revision signed by the parties hereto. Lessee acknowledges receipt of a signed copy of this Agreement.
'RIVERS
E Q U I P M E N T
WHOLE GOODS RELEASE FORM
Contract# / 3 /
Albuquerque NM (505) 884-2900 Cheyenne WY (307) 638-8669 Colorado Springs CO (719) 475-1100 El Paso TX (918) 598-1133 Farmington NM (505) 326-1101
Frederick CO (303) 833-5900 Fort Collins CO (970) 482-7154 Greeley CO (970) 356-3666 Hobbs NM (575) 392-6923
Pueblo West CO (719) 547-3505 Rocky Ford CO (719) 254-7621 Strasburg CO (303) 622-4207
Customer We lc( C 0t,, ` -t - v
Contact leviy
Transaction: Rental X RPO
Cell #
Demo
Holly CO (719) 537-6551 Lamar CO (719) 336-7751
Job/ us /W/O# / C
Loaner
PO#
Sold Transfer Consignment
Equipment
Stock #
Serial #
SMM/Plate
Hours Out
Hours In
L- i
t(L
l c !' i i- Li! r
;1 / ‘
7 i )
9 2 3 /
r
1! . I c,7.--- E. 1 C.
i
Date OUT S / ► c / , Time
Checked OUT by T( KEYS?
\Pi/
Specific Destination
Pictures 5 / I S
Security Code Set
Date IN
Time
Checked IN by KEYS?
Transported by Customer 4RE Name of Company/Driver
Returned by Customer 4RE Name of Company/Driver
IY=Yes N=No ✓=Ok M=Missing L=Low N/A *=See Notes %=Remaining Wear
i
Safety Inspection
1 -Steering Lock/Boom Lock
2 -Seat Belts
3-Brakes/Parking Brake
4-Glass/Mirrors
5 -Back-up Alarm/Motion Alarm
6 -Horn
7 -Manuals - Operator's & Safety / Parts
8-Radio/Antenna
9-Steps/Handles/Non-Skid
10 -Lights Quantity Beacon
11 -Load Chart
12 -Fire Extinguisher 4 g/dischg)
13-ROPS
14 -Emergency Shutdown
15 -Angle Indicator/Level Indicator
16 -Out Rigger/Stabilizer Condition
17 -Tire% Frontl u / Inner 90 /
18-Tracks/Tires/Mudflaps (Damage)
19 -Wipers Functional
20-SMV/Warning Triangle Kit
OUT
✓
✓
V
IN
(chg/dischg)
Reuel U /
V
Notes Out: 3O) Ivy, >t / et, I- no ,
Condition/Damage Inspection OUT IN
21-Fuel/DEF Level (should be full in / out) T.A I 1 /_
22 -Cooling System Levels
23-Hydraulic/Compressor Fluid Level
24-Transmission/Swing Motor Fluid Level
25-Belts/Hoses/Visible Fluid Leaks
26 -Engine Oil Level
27 -Last Service Type 3 k @ L L hrs ■ @ hrs
28 -Air Induction System/Filter Condition
29 -Hydraulic Cylinder/Rod Condition
30-Paint/Sheet Metal Condition
31 -Lug Nuts Checked
32 -A/C - Heater Checked
33-Edge/Cleaner Condition — %
34 -Teeth Cond./Type/# % %
35 -Return to dig/Height kick out/Carry all
36 -Machine Appearance
37 -Cab Interior Appearance
38 -Attachment Condition
39 -Breaker Point Chg $ per 1" worn
40 -Customer Responsibility Decals
4
■
Notes in:
p
I certify the above machine hats been delivered to me in good condition at the location indicated.
Signature X 1
Title
Customer shall indemnify 4RE against all loss or damage to the equipment while it is out of 4RE's possession. Customer assumes all risk and liability in
connection with the operation of this equipment and shall hold 4RE harmless from all damages.
Revised 2/17/15
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