B&G: E&S Check Out Sheet

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Start of Rental

• Asset #- Picture

  Media

• Asset #- written

• Unit Serial # - Picture

  Media

• Unit Serial # - Written

• Equipment Type

• Fluid Levels- oil, Hyd, coolant, transmission

• Meter Mileage / Hours

• How much fuel is in the unit?

  Full

  3/4

  1/2

  1/4

  Empty

• Tire/ Track Condition

  Media

• Lights

  Media

• Pictures Of Outgoing Equipment

  Media

Additional Details

• Key

  Yes

  No

  N/A

• Carrying Case

  Yes

  No

  N/A

• Gas Can<br>

  Yes

  No

  N/A

• Wrench

  Yes

  No

  N/A

• Operational Manual

  Yes

  No

  N/A

• Fire Extinguisher

  Yes

  No

  N/A

• Backup Alarm

  Yes

  No

  N/A

• Horn

  Yes

  No

  N/A

• Seat Belt

  Yes

  No

  N/A

Damage Details

• Note any damage at the start of the rental

All functions are working properly

• I have thoroughly checked the machine and agree with the assessments stated above. I have had the opportunity to note any previous damage to this machine. I understand that if B&G Equipment delivers the equipment, I must call for a pickup number to stop the rental. I also agree that once a pickup number has been issued, I will place the equipment in an area that can be accessed by the driver.

• Customer

  Sign

• B&G Employee

  Sign