Loaner Request Form Loaner Request Form Shop Name(Required) Your Name(Required) First Last Phone(Required)Email(Required) Shipping Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country What loaner is needed?(Required) Invertaspot GT Gun XPress 800 Taurus 4 Other XPress PowerPack Short Stroke Cylinder JLR Short Stroke Cylinder PushPull Cylinder BR20 BR50 BR80 BRN50 Small C-Arm Medium C-Arm Large C-Arm Please enter name of tool loaner is needed for: Invertaspot GT Non-Automatic GT Automatic GT (circle connector to welder) Automatic GT UL Gun (rectangle connector to welder) Borrower Obligations This Agreement outlines the obligations of the Borrower, which cannot be transferred without the written consent of the Lender. By signing this Agreement, the Borrower agrees to adhere to the following terms: A. Insurance The Borrower is responsible for the full cost of repairing or replacing any or all of the Equipment that becomes lost, damaged, confiscated, or stolen from the moment the Borrower takes possession until it is returned to the Lender. If the Equipment is lost, stolen, or damaged, the Borrower must notify the Lender Representative designated above in a timely manner. B. Use/Disclaimer The Borrower is responsible for the appropriate use and deployment of the Equipment. The Borrower must ensure that anyone who uses the Equipment is properly trained on its correct use in accordance with the Equipment use procedures. C. Delivery and Return of Equipment The Borrower is responsible for ensuring the safe packaging, proper shipping, and receipt of the Equipment upon its return. The Equipment must be returned within a reasonable time after the end of the Loan Period as specified. If the Borrower fails to return the loaned Equipment or does not respond to the Lender, they agree to purchase the loaned Equipment at the list price. The Equipment shall be returned to: Reliable Automotive Equipment Attn: Service Department 58 Leonardville Road Belford, New Jersey 07718 D. Maintenance and Repair The Equipment must be returned to the Lender in the same condition as it was received by the Borrower, except for normal wear and tear. The Borrower is responsible for any damage caused to the Equipment while it is in their possession or during the return process due to inadequate packaging. E. Communication The Borrower agrees to maintain communication with the Lender throughout the term of the agreement. The Borrower must respond to the Lender’s communications within a reasonable period of time (e.g., repair quote for a broken device). If the Borrower fails to respond to the Lender’s communications and does not return the loaned Equipment, they agree to purchase the loaned unit at the list price. F. Indemnification As a condition for borrowing the Equipment, the Borrower agrees to indemnify, defend, and hold the Lender harmless from any and all damages, losses, claims, causes of action, expenses, and liabilities of any kind stemming from the use of the Equipment while under the Borrower’s care, custody, and control, unless it is due to the Lender’s negligence. Agreement(Required) I agree to the loaner request policyCommentsThis field is for validation purposes and should be left unchanged. Δ
