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513-202-0001
1-800-710-2987
513-202-1444
5945 Dry Fork Road • Cleves, Ohio 45002
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Machine Information (help us with whatever info you know)
Brand Name
Type
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Air Fan
Backpack Vacuum
Carpet Extractor
Carpet Vacuum
Electric Buffer
Pressure Washer
Propane Buffer
Rider Scrubber
Rider Sweeper
Walk Behind Scrubber
Walk Behind Sweeper
Other
Other
Model
Serial Number
Seeking Information on reconditioning program
Yes
Seeking information on Planned Maintenance programs (PM’s)
Yes
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Jobsite Contact
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Hazardous or Flammable Materials
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I certify unit will not be used with floor sealers, strippers, densifiers or flammable materials
Type of Rental Unit
LP Gas Rider Sweeper
LP Gas Rider Scrubber
Battery Rider Scrubber
Battery Walk Behind Scrubber
Gas Pressure Washer
Electric Pressure Washer
Surface Cleaner
(Please note: LP tank not included with machine cost and is extra)
Need LP
Yes
No
Number of Tanks
Floor Condition
New, no high gloss coating
High gloss or coated floor
Plain concrete
Plain Concrete
Rough
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Smooth
Desired Brush
Brush
Aggressive
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Pads
Pad Color
Type of Dirt
Oil
Metal Chips
Dust
Tire Marks
General Dirt
Need Chemicals
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Does Application Include:
Parking Garage
Hazardous or Flammable Material
Building Access
Dock
Ground & Ramp
Both
Date Needed
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Date Returning
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