5 Kingsford Smith St, (P O Box 7121), TAMWORTH NSW 2348

Tamworth Pty Ltd ABN: 760 825 24403 5 Kingsford Smith St, (P O Box 7121), TAMWORTH NSW 2348 Ph: 6762 2606 F: 6765 2111 M: 0407 255 013 Email: [email protected] Ag-Quip 2016 Cart Hire

CUSTOMER INFORMATION FORM Miss/Ms/Mrs/Mr First Name: ...... Surname: ...... Address: ...... Post Code: ...... Home Phone: …...... Mobile:...... Email: ...... Business Name (if claimable): ...... Business Address: ...... Please tick the hire cost that relates to you and circle cart required.

□ You are over 55 or have an aged pension card or a disability or a medical certificate: Hire of 2 Seater Golf Cart per day $220.00 incl gst and damage waiver Hire of 4 Seater Golf Cart per day $264.00 incl gst (booked out) Hire of 6 Seater Golf Cart per day $330.00 incl gst (booked out) **$110.00 Deposit for Carts is to be paid to guarantee your cart

Information/Comments: ...... …...... □ You are under 55 and do not have any of the above mentioned certifications: Hire of 2 Seater Golf Cart per day $690.00 includes gst and damage waiver Hire of 4 Seater Golf Cart per day $920.00 (booked out) **Payment in full must be made to guarantee your cart. □ You are hiring a vehicle in the name of a business: (driver to be over 30 yrs) Hire of 2 Seater Golf Cart per day $220.00 incl gst and damage waiver Hire of 4 Seater Golf Cart per day $264.00 incl gst (booked out) Hire of 6 Seater Golf Cart per day $330.00 incl gst (booked out) **Payment in full must be made to guarantee your cart.

Day cart Required: Tuesday 16th ( ) Wednesday 17th ( ) Thursday 18th ( ) ● We will need a photocopy of any relevant medical certificates ● All drivers are to provide a photocopy of their licence ● A 15% Damage Waiver and gst is included on all hires PAYMENT DETAILS (Please tick preferred payment method) □ CREDIT CARD Please debit my: [ ] Visa [ ] MasterCard Expiry Date: ___/___ Credit Card No: ______Cardholder Name: ...... Amount $...... Signature: ...... ______□ CHEQUE Please address cheque payable to: DTM Tamworth ______□ DIRECT DEPOSIT Name: DTM Tamworth Bank: ANZ Tamworth BSB No: 012 830 Account No: 496290768 **Please note the surname that the cart booking has been made under as your direct deposit reference. Please fax your remittance advice to 6765 2111 or email to [email protected] ______TERMS & CONDITIONS OF HIRE No children or persons under 25 years of age are permitted to operate the hire vehicle at any time. If children are found operating a hire vehicle the lessee may be fined by the police or the hire cancelled. The hirer hereby indemnifies the owner against claims, actions, suits or demands whatsoever nature by the hirer or any other person arising out of the use or operation of the golf cart. The deposit paid in guarantee of hire is non-refundable and is required to be paid to secure a cart, otherwise bookings will be taken on the day. All carts must be returned to SITE AA-BB/20 by 5.30 pm each day or a late fee of $50 will be charged.

For your booking to be confirmed we will need: Completed Ag-Quip Customer Information Form Photo copy of driver’s licence (licence to be sited on day of hire) Photo copy of medical certificates Deposit or full payment

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