B&B Rentals

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Fill out this form to place an order. This order form is secure, your information will be protected by a 128-Bit encryption.
Items marked with * are required.
Date:
*
Date Needed:
(M-F only)
*
Property Name:
*    
Resident Name:
*
Referred By:
*
Resident Address:
*
Unit #:
*
Apartment Floor:
*
   
City:
*
Zip Code:
*
Drivers License:
*
Home/Cell Phone:
*
Employed By:
*
Work Phone:
*
Email:
*    
       
Initial Payment Information
 
Credit Card #:
*
Expiration Date:
*
Name as appears:
*
CC Type:

AMEX *

Billing Address:
*
3/4 Digit Security Code:
*
Billing Zip Code:
*
Automatic Payment:

*

Rental Product Selection (please select items)
       
Refrigerators
     
       
Size:





Handle:



   
Other
 
   
Side-By-Side:

Washer $22.50
Gas Dryer $22.50
Electric Dryer $22.50

   
Stack Laundry:
Electric $60
   
Monthly Rate:
*
Delivery (one-time):
$75
Total Initial Payment:
*
   
Notes:

Terms and Conditions

The above items are an accurate listing of the lease property (hereinafter called "Leased Property"). Resident (hereinafter called “Resident”) agrees to lease such from B & B Appliance & Houseware Rentals (hereinafter called “B&B”) and to keep the Leased Property at the address above pursuant to the terms and conditions set forth herein. In the event that the Resident removes Leased Property from the above address, B&B is not responsible for damage or injury due to misuse or improper operation / installation of Leased Property and Resident bears full responsibility for said damages / injuries as well as any damages to Leased Property itself. Minimum rental term is 3 months and will continue on a month to month basis thereafter until termination of Rental Agreement.
 
Resident may terminate this lease following the minimum rental term by giving fifteen (15) days notice to B&B. Failure to give fifteen (15) days notice will result in a prorated charge not to exceed fifteen (15) days of rent. B&B may terminate lease with thirty (30) day written notice for nonpayment of rent. Upon termination, Resident will make the Leased Property available to B&B at a time that is convenient to B&B and will permit B&B or it's agents access to Resident premises for the expressed and sole purpose of recovering Leased Property.
 
I hereby grant B&B permission to enter the premises listed above for the expressed and sole purpose of delivering and or recovering Leased Property. I further authorize the building owner or his representative to permit access to and release said Leased Property to B&B and hold such owner and / or representatives harmless for their actions, or any other actions, from such entry.

 
I certify that I have read and accept the terms and conditions above and grant B&B permission to enter the above premises for the expressed and sole purpose of delivering / recovering the Leased Property. In the event that my account becomes past due, I specifically authorized you to charge all outstanding amounts due and any other costs reasonable to recover Leased Property, if applicable, to my credit card on this application, and agree to keep said credit card in good standing for the duration of this lease.
By checking this box, you agree to our Terms and Conditions statement above (Required).
Items marked with * are required.
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