Online Rental Credit Application

Other principals in partnership or corporation
Principal 1
Principal 2
Files must be less than 12 MB.
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Bank Reference
Trade References
Trade Reference 1
Trade Reference 2
Trade Reference 3

By signing below on behalf of your business, you represent that your business is a valid business entity, that all purchases made on this account, if approved, will be for valid business purposes, and that you are an authorized representative of the business with authority to enter into contractual agreements. On behalf of the business, you certify that all information provided in this application is complete and accurate, and you authorize clark equipment rental to verify information about you personally and your business in considering this application and subsequently for purposes of updates, renewals, or collecting the account.

A 1% per month late charge will be assessed on all invoices that are more than 30 days past due. A $50 charge will be assessed on all nsf checks. Collection costs and expenses will be the buyer’s responsibilty. Said costs and expenses shall include reasonable attorney fees.

Certificate of Insurance Requirements

RENTER agrees to maintain the following insurance at their own expense:

COMMERCIAL GENERAL LIABILITY
Bodily Injury and Property Damage: Limit $1,000,000 each occurrence
Products/Completed Operations: Limit $2,000,000 aggregate
Personal Injury & Advertising Injury: Limit $1,000,000 each person/org
General Aggregate: $2,000,000

The policy shall be endorsed to name CLARK EQUIPMENT RENTAL & SALES, INC. as an Additional Insured on a primary and non-contributory basis.

BUSINESS AUTO LIABILITY

Combined Single Limit of Bodily Injury & Property Damage: $1,000,000.00
Coverage to Include: Owned, non-owned and hired automobiles.

WORKMAN’S COMPENSATION AND EMPLOYERS LIABILITY
Coverage A: Statutory
Coverage B: $100,000 /$500,000/$100,000

UMBRELLA/EXCESS LIABILITY
Bodily Injury and Property Damage Limit: $1,000,000 each occurrence / $1,000,000 aggregate

PROPERTY / INLAND MARINE (for equipment leased without operators)

Coverage on an “ALL RISK” basis. All such equipment is to be insured to 100% of its FULL MARKET VALUE, or to the limit as designated. Clark Equipment Rental & Sales Inc TO BE NAMED AS LOSS PAYEE.

ADDITIONAL REQUIREMENTS:

  • Clark Equipment Rental & Sales Inc. shall be notified not less than 30 days prior to cancellation or non-renewal of any of the aforementioned required coverages
  • Waiver of Subrogation in favor of Clark Equipment Rental and Sales Inc. shall be included on all policies
  • A certificate of insurance shall be provided prior to rental inception and shall include a copy of the Additional Insured, Loss Payee and Waiver of Subrogation endorsements shall be included with all certificates

Please contact your insurance company and request that they issue to Clark Equipment Rental & Sales, a certificate of insurance for a minimum of $1,000,000.00 combined single limit showing endorsement with Clark Equipment Rental & Sales, Inc., as Additional Insured. Also, please request FIRE, THEFT, VANDALISM and EXTENDED COVERAGE insurance in an amount equal to or greater than the value of the equipment rented, naming Clark Equipment Rental & Sales, as LOSS PAYEE with a maximum deductible of $1,000.00.

I will provide the certificate of insurance to Clark Equipment Rental & Sales as requested.