Renter

#TRIP_PASS_FNAME# #TRIP_PASS_LNAME#

#TRIP_PASS_PHONEMOB1#

Alternate Contact

#TRIP_ALTCONTACT#

#TRIP_CLIENTREFNUMBER#

#TRIP_ALCONTACTPH#

Driver

#TRIP_DRIVER1_FNAME# #TRIP_DRIVER1_LNAME#

Party Bus

#TRIP_CAR1_CODE#

Rental Date

#TRIP_PUDATE#

Occasion

#TRIP_OCCASION#

Pick-Up

#TRIP_PUTIME#

#TRIP_RT_PUBLOCK#

Drop-Off

#TRIP_DOTIME#

#TRIP_RT_DOBLOCK#

Destinations

#TRIP_RT_STBLOCK#

Rental Instructions

#TRIP_NOTES_MAIN#

Dispatch notes

#TRIP_NOTES_DRIVER#  #TRIP_NOTES_BCPASS#  #TRIP_GREETING_SIGN_NOTES#

The Breakdown

Hourly Fee

$#Rate_ID_251512#

Flat Fee

$#Rate_ID_364582#

Cleaning

$#Rate_ID_379815#

Rental Total

$#TRIP_RATES_TOTAL#

Amount Paid

$#TRIP_PAYMENTS_NOAUTH#

Mileage

$#Rate_ID_379816#

Discounts

-$#Rate_ID_379817#

Gratuity

$#Rate_ID_379818#

Balance Due

$#TRIP_RATES_TOTALDUE#

Driver

#TRIP_DRIVER1_FNAME# #TRIP_DRIVER1_LNAME#

Prior end of duty

Date

Time

Prior 7 Days

Total Hours

Time Clock

Clocked In

Clocked Out

Hours

Date

Time

Date

Time

Total

Date

Time

Date

Time

Total

Gratuity

Credit Card

Cash For Taxes

Odometer

Starting

Ending

Total Mileage

Post-Trip Vehicle Inspection

Service brakes

Parking Brake

Steering Mechanism

Windshield Wipers

Tires

Wheels & Rims

Emergency Equipment

Horn

Rear Vision Mirrors

Lighting Devices

Reflectors

Condition of Vehicle

Satisfactory

Unsatisfactory

Remarks

Driver Signature

I certify this form is accurate to the best of my knowledge.

Signature

Mechanic

Defects CorrectedDefects Need not be Corrected

Signature

Date