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Free Loaner Car

Free Loaner Car

Your Information

Name

Phone

Email

Please check all and sign:

I am licensed to drive a vehicle in the state of:

I am 21 years of age or older

I presently have in effect collision and liability insurance that will cover this loaner vehicle while in my possession

I will personally be responsible for all deductibles and expenses not covered by my insurance

I will return the vehicle with the fuel at the same level as when I take the vehicle. Or I will be charged $4.00 a gallon to my bill to have it filled it back up.

I will not use this vehicle negligently or contrary to law. Nor will I permit others to operate this vehicle

I agree that the vehicle will not be taken outside of a 50-mile radius of Dale’s Service Center. If the vehicle is taken outside of the 50 miles radius I agree to pay all roadside and/or towing expenses if needed.

I agree to not smoke in the vehicle or have pets in the vehicle at any time.

I agree to make sure all clutter and garbage will be removed before returning the vehicle to me. Or I will be charged for a min $18.00 to clean vehicle

I agree to pay for any fines, penalties, forfeitures, and court costs imposed that I may receive while the vehicle is in my possession. Such as red light camera tickets, speeding tickets, parking tickets, seat belt tickets. The Renter/Driver will promptly report such violations to DSC Auto LLC harmless from all claims arising from all such violations.

Authorized renters/drivers releases and hold harmless DSC Auto LLC “ and its agents and employees from all claims for loss or damage to his/her personal property or that of any other person, which is left or carried in or upon the vehicle or in or upon any other vehicle or upon any other vehicle or premises of the DSC Auto LLC by authorized driver, or by any other person, or which is received, handled or stored by the company, at any time before, during or after this rental, whether or not due to DSC Auto LLC negligence or fault.

This vehicle will not be used (1) by other than an authorized driver; (2) to push or tow anything, carry persons or property for hire, in a race, test, contest or training activity; (3) For any illegal purposes or in the commission of a crime’ (4) while under the influence of alcohol or drugs; (5) to initially cause damage or engage in willful wanton or reckless misconduct; (6) Outside of our geographic driving restrictions and in any event outside of Canada and the US; (7) If it was obtained by fraud or misrepresentation.

Liability Insurance - DSC Auto LLC has obtained all mandatory automobile insurance as required by law with respect to the VEHICLE, by driving this vehicle authorized drivers are agreeing to comply and be bound by all terms, conditions, limitations, and restrictions of this insurance policy which are made a part of this rental agreement. DSC Auto LLC will not provide “underinsured motorists”, “supplemental”, “no-fault”, or any other optional insurance coverage unless such coverage is required by law to the extent permitted by law, the renter/drivers and the DSC AUTO LLC reject the inclusion of any such option coverage.

Please scan and upload your driver's license and insurance card

Attachments

By signing this agreement, I understand that I will be responsible for all damage incurred while the vehicle is in my possession.

I accept the Privacy Policy

I agree to opt-in for marketing & non-marketing postcards, emails or calls/text messages via automated systems or other electronic means to any phone number, email or local address I have provided. For more information, please review our Marketing Policy