EMERGENCY EQUIPMENT RENTAL AGREEMENT (CONTINUATION)	Page    of   	
1. AGREEMENT NUMBER (Must appear on all documents relating to this agreement):
     	
2. ITEM DESCRIPTION: equipment or animals (include VIN, make, model, year, serial no., accessories or other identifying features).	3. NO. OF OPERATORS 
PER SHIFT	4. HRLY/DAILY/MILEAGE/
SHIFT BASIS (ss/ds; ref. Cl.6)	5. SPECIAL	6. GUARANTEE
(8 HOURS)	
					
		Rate	Unit			
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
     	  	     	     	     	     	
7. CONTRACTOR’S OR AUTHORIZED AGENT’S SIGNATURE	8. DATE
          	10. CONTRACTING OFFICER’S SIGNATURE	11. DATE
     	
				
		a. Warrant No.       		
9. PRINT NAME AND TITLE
     	12. a. PRINT NAME AND TITLE	
	     	
	b. Phone Number:      	c. FAX:      	
OPTIONAL FORM 294a (DRAFT)