YOUR DETAILS

Full Name or Company Name:

Invoicing Address:

Trade of Business:

Company Reg. No.:

Business Type:

YOUR BUYING DETAILS

Contact Name:

Buyer Email:

Buyer Contact No:

Buyer Fax No:

YOUR ACCOUNT DETAILS

Contact Name:

Accounts Email:

Accounts Contact No:

Accounts Fax No:

YOUR BANK DETAILS

Bank:

Account Name:

Branch:

PLANT INSURANCE - DAMAGE WAIVER

If you have your own Contractors Plant Insurance then please indicate below, we will require a copy of your ‘hired plant’ insurance policy to be sent in. Alternatively you could take advantage of

Provide by scan or fax, a copy of your HIRED IN PLANT INSURANCE cover
Use JPS PROTECT - PLATINUM added invoice at 20% of the hire charge only
Use own insurance and JPS Damage Waiver Cover, PROTECT - GOLD at 10% of the hire charge only

GUARANTEE

Please read and sign below:

I understand that prior to hiring equipment my company must have adequate insurance coverage, competent
operators, and that I have read and accepted the JPS Platforms Ltd Terms and Conditions.
I consent to JPS Platforms Ltd, processing and storing my personal data, in line with the requirements highlighted within their Privacy Policy.

Signature of Director/Proprietor:

Full Name: