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Rental Agreement
For all Company/Business requiring rental goods please fill in the top section
ACN/ABN
Company/Business Name
Company/Busniess Address
Company/Business Suburb
Company/Business State	New South Wales Western Australia Queensland Victoria South Australia Northern Territory Tasmania Australia Capital Territory
Company/Business Phone Number
Person responsible for good/s and this person must be present when goods are delivered to sign agreement.
Gender *	Mr Mrs Ms Dr
First Name *
Middle Name
Last Name *
Birth Date *	Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900
E-mail *
Phone/Mobile *
PLEASE WRITE WHOLE ADDRESS INCLUDE POSTCODE.
Current Address *
Delivery Address(only if different to above address)
State *	New South Wales Western Australia
How long at current address *	0-6 months 7-12 months 1-2 years 3-5 years 5 + years
Residental Status *	Owner Renting Boarding Sharing Living with Parents
Previous Address(if at current address shorter than 3 years)
EMPLOYMENT DETAILS
Employment status *	Full Time Part Time Casual Self Employed unemployment benefits retired pension retired self funded semi retired
Company Name
Company Address
State	New South Wales Western Australia Victoria Queensland Australian Capital Territory South Australia Northern Territory Tasmania
Business Number
Business Email
REFERENCES
Please supply; 1 referee for 1 week agreement, 2 referees for 1 month agreement, 3 referees for 3 month agreement.Please note no referees from the same place of rental.
1st Referee (the first referee must be filled out for all lengths of agreements)
Gender *	Male Female
First Name *
Last Name *
Relationship *
Address *
State *	New South Wales Western Australia Victoria Queensland South Australia Northern Territory Australian Capital Territory Tasmania
Contact Number *
E-mail(if any)
2nd referee (must be filled out for 1 month and 3+ month agreements)
Gender	Male Female
First Name
Last Name
Relationship
Address
State	New South Wales Western Australia Victoria Queensland South Australia Northern Territory Australian Capital Territory Tasmania
Contact Number
E-mail(if any)
3rd referee (must be filled out for 3+ month agreements)
Gender	Male Female
First Name
Last Name
Relationship
Address
State	New South Wales Western Australia Victoria Queensland South Australia Northern Territory Australian Capital Territory Tasmania
Contact Number
E-mail(if any)
How did you find us? *	Google Yahoo MSN Bing Newspaper Referred other
Please click on the rental product/s you wish to rent.
*warning* have your worked out which rental goods will fit your situation, if not go to the FAQ section that suits you. Please choose carefully, as if we have to come out to replace it with an up grade extra costs will be involved.
Cool Or Cozy Rentals products for cooling
LengthAgreement *	12 hour rental Air Cooler only 24 hour rental Air Cooler only weekend rental 1 week rental 1 month rental 3+ months rental CooLRent Buy weekly CooLRenT BuY monthly HoTRenT BuY weekly HoTRenT BuY monthly
Portable Air Conditioners
1st units size	nil small 10-16sqm medium 17-25sqm large 26-34sqm
2nd units size(display nil if not needed)	nil small 10-16sqm medium 17-25sqm large 26-34sqm
3rd units size(display nil if not needed)	nil small 10-16sqm medium17-25sqm large 26-34sqm
4th units size(display nil if not needed)	nil small 10-16sqm medium 17-25sqm large 26-34sqm
Portable Air Coolers/Evaporation units
Indoor units(display nil if not needed)	nil 1 unit 2 units 3 units 4 units 5+ units
Outdoor units(display nil if not needed)	nil 1 unit 2 units 3 units 4 units 5+ units
Cool Or Cozy Rentals products for heating
Portable indoor heater 1st unit(display nil if not needed)	nil 15mj 18mj 21mj 25mj 15mj convection 18mj convection 21mj convection 25mj convection electric oil small electric oil medium electric oil large electric ceramic panels electric fire places
2nd portable indoor gas unit(display nil if not needed)	nil 15mj 18mj 21mj 25mj 15mj convection 18mj convection 21mj convection 25mj convection
3rd portable indoor gas unit(display nil if not needed)	nil 15mj 18mj 21mj 25mj 15mj convection 18mj convection 21mj convection 25mj convection
4th portable indoor gas unit(display nil if not needed)	nil 15mj 18mj 21mj 25mj 15mj convection 18mj convection 21mj convection 25mj convection
Patio heaters : Gas bottles
Gas patio heater	nil 1 patio gas heater 2 patio gas heaters 3 patio gas heaters 4 patio gas heaters 5 patio gas heaters
Full gas bottle rental.If you don't need any leave as nil	nil 1 full gas bottle 2 full gas bottles 3 full gas bottles 4 full gas bottles 5 full gas bottles
Electric patio heater	nil 1 patio electric heater 2 patio electric heaters 3 patio electric heaters 4 patio electric heaters 5 patio electric heaters
Mist fans : These are perfect for indoor or outdoor sporting events, as you or your team can cool down and have that edge over your opponents
Large mist fans	nil 1 large mist fan 2 large mist fans 3 large mist fans 4 large mist fans 5 large mist fans
Would you like to receive any of the following:	special offers promotions clearance sales
Aged Pension discount	aged pension
I hereby agree to comply with the terms and conditions(click on terms & conditions on the nav.bar) set out by Cool Or Cozy Rentals *	I agree
I hereby declare that I'm(the renter) 18 years or over of age. *	I'm 18 or over
So what happens now?
What you will need when your Cool Or Cozy Rentals goods arrive : A current photo ID, a bill with your name and address on it(not Company/Business agreements).If you are renting as an old age pensioner please have your card available.The person submitting the agreement must be at the delivery address to sign the agreement contract unless otherwise organized with the office before delivery.If paying by cash please have exact monies as we don't carry money for obvious reasons.