Bendigo Coolroom Hire - Hire Agreement Form

(Eagle Enterprises Group Pty Ltd, trading as Bendigo Coolroom Hire - ABN: 66 663 265 781)
Bendigo Coolroom Hire - Hire Agreement Form

Please complete all sections to finalise your mobile Coolroom/Freezer Hire.
Name of Hirer*

First NameLast Name
Business/Organisation (if applicable)
ABN (if applicable)
Residential Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Mobile/Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Driver’s Licence Number*
Place of Issue (Driver’s Licence)*
Licence Expiry Date*

MonthDayYear
Date
Take Photo of License
Upload Photo of license if you cannot take a photo above

Cancelof
Mobile Coolroom/Freezer Unit (Invoice No.)*
Hire Period - From*

MonthDayYear
Date
Hire Period - To*

MonthDayYear
Date
Same as Residential addressDifferent than Residential address
Delivery/Site Address (If different than residential address)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
How have you found the quality of the product and service so far?
Further Comments (Feedback/Review)
Digital Signature of Hirer*
Should be Empty: