RENTAL AGREEMENT 
 FORM SA/04  (PRIMO RADIAL SHOCKWAVE THERAPY UNIT)
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Primo Radial Shockwave Therapy Unit
Telephone number (inc extension if req) *
Contact name in full *
Date: *
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Invoice address (inc postcode) *
Delivery address (leave blank if same as invoice address)

AGREEMENT between the client and EMS Physio Ltd , the supplier

 1.     The client agrees to rent the equipment listed below for a minimum period of three months from the date shown above.

2.     The client agrees the equipment has been delivered in good working order without visible marks, scrapes, dents etc.  Please detail any such marks within 48 hours of receipt of equipment.

3.     The supplier retains ownership of the equipment at all times during the rental period.

4.     Every effort should be made by the client to ensure the equipment is maintained in good condition. The supplier reserves the right to immediately withdraw the equipment and cancel the agreement without refunding payments, should the supplier consider the equipment has been damaged irresponsibly.

5.     Payment will be taken monthly, in advance, from a credit/debit card or standing order/BACS.

6.     The supplier reserves the right to withdraw the equipment immediately should payment be overdue or card be refused.

7.     The client may cancel the agreement (after the first three months), but must give at least 30 days notice, in writing.

8.     The client must have the unit ready for collection, as arranged with the supplier.

9.     The supplier should be allowed access to inspect the equipment should the need arise.

10.   The supplier shall include a two year warranty for the equipment and an annual service.

11.   At anytime during the rental period, the unit can be purchased, and 3 months rental payments paid to date will be deducted from the catalogue price at the beginning of the rental period.

12. Rental of equipment from EMS Physio is for professional use only and for use by a qualified practitioner

Please enter your name below to accept the agreement terms

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Thank you for providing your information. We will contact you to arrange to set up monthly payments.

The first payment is £424.75  which is inclusive of carriage both ways and VAT
Monthly hire fee is £304.75 inc vat

As per the terms of rental above the minimum hire period is 3 months.

BANK NAME:  HANDELSBANKEN PLC
ACCOUNT NAME: EMS PHYSIO LTD 
SORT CODE: 40-51-62 
ACCOUNT NUMBER: 50164940 

CREDIT/DEBIT CARD CALL: 01235 772272 VISA. MASTERCARD  

 All accounts enquiries and remittance advice to 
Richard Milsom Tel: 01235 774169 
Email: RMilsom@emsphysio.co.uk  
Once you have submitted this form we will contact you with delivery information/ take the first payment payment, set up standing order and book your manufacturer training.

Thank you for choosing EMS Physio Ltd
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