Choco Fountain Inc.

Attended Local Rental Agreement

Phone 308-382-4050 Today’s Date__________________ Fax 308-382-7324

CLIENT INFORMATION

Customer’s Name________________________________________________________________________

Address________________________________________________________________________________

City_____________________________________________ State____________ Zip __________________

Phone_________________________ Cell_________________________ Fax________________________

Email__________________________________________________________________________________

EVENT INFORMATION

Event Date: ______________________________ Event Start Time: _____________________________

Event End Time (3 hours time included without additional charge):__________________________________

Name of Location:________________________________________________________________________

Street Address: ________________________________________________________________________

City: ___________________________________________ State: _________ Zip: ____________________

Contact: ________________________________________________ Phone: ________________________

BILLING INFORMATION

Type of Payment: Cash_____ Check_____ Credit Card______ Debit Card______ Credit Certificate_____

Visa______ MasterCard______ Discover______ American Express______

Credit Card #________________________________________________________ Exp________________

Name_________________________________________________________________________________

Address________________________________________________________________________________

City___________________________________________ State____________ Zip ____________________

Phone (If not same as Client)_______________________________________________________________

CHARGES

Type of Fountain Rental: Small__________ Medium__________ Large__________ = $_____________

Chocolate: Dark Milk White (5 lbs@$29.95) _______lbs. = $_____________

Dipping Items: Strawberries Pineapple Bananas ___________________ @ $2.99/Guest =$_____________

Misc: Additional Time _______ Mileage ________ Other________________________=$_____________

Tax (If applicable). . . . . . . . . . . . . . . . . . . . . . . . . . . . = $_____________

TOTAL CHARGES . . . . . . . . . . . . . . . . . . . . . . . . . . . =$_____________

Prepayment (Refundable only as future credit). . . . . . . . . . . . . . . . . = $_____________

BALANCE DUE (5 Days Prior to event) . . . . . . . . . . . . . . . . . . . . = $_____________

TERMS & CONDITIONS

I. RESERVATION & PAYMENT

Reservation of the Choco Fountain is done by faxing, emailing (with scanned signature), mailing, or returning this completed agreement to Choco Fountain Inc. The Customer agrees to put a credit card on file or complete a Choco Fountain Inc. credit application for prepayment. The Customer shall compensate Choco Fountain Inc. a $150 (one hundred fifty dollars) prepayment to reserve the fountain. The balance due will be charged to the Customer’s credit card 14 days prior to the date of the event.

II. CUSTOMER CANCELLATION & REFUND POLICY

Cancellation of Agreement by Customer must be done 30 days prior scheduled event date. The prepayment refund will be in the form of a Choco Fountain Inc. Credit Voucher to be used on the next fountain rental. Choco Fountain Inc. will not allow any refunds on cancellations less than 30 days prior to the event date.

III. PROVISIONS

Choco Fountain Inc. requires access to the desired set-up area at least 60 minutes prior to the scheduled start time. In addition 60 minutes are required after the conclusion of the service period for take down and removal. The client is responsible for providing a sturdy, level table capable of supporting 200 lbs. Client is also responsible for providing 2 table linens that coordinate with their color scheme. Choco Fountain will require at least one 120VAC outlet within 10 (ten) feet of the desired set-up area that complies with contemporary safety standards and supplies at least 15 amperes. Client accepts full responsibility and is liable for any damages , injuries or delays that occur as a result of failure to comply with these provisions. Choco Fountain Inc. reserves the rights to use any photographs from this event for promotional purposes.

IV. CHOCO FOUNTAIN SHALL NOT BE LIABLE

This Agreement and the contents hereof represents the only warranties, express or implied, between parties, including any implied warranty or merchantability or fitness for the particular purpose and for any other obligation or liability on the part of Choco Fountain Inc. Choco Fountain Inc. shall not be liable for any injury, loss or damage directly or consequently arising out of the use or inability to use the rented fountain(s), whether used singularly or in conjunction with any other equipment. The Customer will indemnify Choco Fountain Inc. against, and hold Choco Fountain Inc. harmless from all claims, actions, proceedings, costs, damages, and liabilities, including attorney fees, arising out of, connected with, or resulting from the rental or use of the fountain(s).

IN WITNESS WHEREOF, This Agreement has been executed and delivered by the Customer and the Customer agrees upon acceptance by the valid execution hereof by Choco Fountain Inc. this Agreement shall be deemed to have been made in, and governed by the laws of, the State of Nebraska.

_____________________________________ ______________________________________

CUSTOMER SIGNATURE CHOCO FOUNTAIN INC.

Name:________________________________ Name:_________________________________

Title:_________________________________ Title:___________________________________

Date:_________________________________ Date:__________________________________

Local Attended Chocolate Fountain Rental

Attended Local Rental Agreement

Phone 308-382-4050 Today’s Date__________________ Fax 308-382-7324

CLIENT INFORMATION

BILLING INFORMATION