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| PUSH CART RENTAL |  | Additional Rental Agreement | ||||||||||
| ORDER FORM | Must Also Be Signed by | |||||||||||
| Customer | ||||||||||||
| PLEASE PRINT LEGIBLY!!!! | ||||||||||||
| DATE REQUESTED: | ||||||||||||
| CUSTOMER NAME: | ||||||||||||
| PHONE: | ||||||||||||
| ALT PHONE: | ||||||||||||
| DELIVERY ADDRESS: | ||||||||||||
| SPECIAL INSTRUCTIONS ie PROPERTY LOCATION/ENTRANCE INSTRUCTIONS, ETC: | ||||||||||||
| ICE CREAM CART SELECTION: PLEASE CHECK ONEl | ||||||||||||
| SMALL | MEDIUM | LARGE | ||||||||||
| $75 per Day | $100 per Day | $125 per Day | ||||||||||
| Plus 1/4 Blk Dry Ice Purchase | Plus 1/2 Blk Dry Ice Purchase | Electric - No Dry Ice Needed | ||||||||||
| $ | $ | |||||||||||
| Holds: | Holds: | Holds: | ||||||||||
| Up to 8 boxes (200 pcs.) | 9 - 15 boxes ( up to 360 pcs) | 15 - 30 boxes (up to 720 pcs) | ||||||||||
| or up to 6 tubs | or up to 8 tubs | |||||||||||
| HOT DOG CART: $125 Per Day | ||||||||||||
| PLEASE LIST YOUR ICE CREAM/ICE SELECTION: | ||||||||||||
| Qty: | Item Code: | Description: | Qty | Item Code: | Description: | |||||||
| TOTAL ORDER: $ | TOTAL ORDER: $ | |||||||||||
