HiddenInitiator's WordPress ID Initiator's EmailWordPress email log in for Burn Debris staff member who created this entry. If blank a customer filled out form on our website. Request Air Burner Rental QuoteComplete this request form and we’ll soon contact you to confirm the cost and dates for renting the air burner(s) you desire.Job Location Address(Required)Where burning will occur. An accurate address is needed to give a cost estimate. Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Start Date (Desired)(Required)Will be confirmed when we call you. MM slash DD slash YYYY Is your start date flexible?YesNoEnd Date (Desired)(Required) MM slash DD slash YYYY Pickup or Deliver?(Required) Will pickup burner Need burner delivered May be able to pickup but need a quote for delivery Company Name(Required) Customer(Required) First Last Phone: Customer(Required)Email: Customer(Required) Rented from us before?(Required) First time renter Have rented before from Burn Debris How did you hear about Burn Debris?Comments (optional)Tell us more about your rental needs?HiddenRental ID HiddenStaff: Review RequestThis section is visible to staff only who reviews the request and approves or deniesHiddenPreliminary Status(Required)Check if a machine is possible considering the requested dates, then complete your Initial Status below. Call Customer Called But Customer Canceled Notify Customer Not Possible Customer Needs Contract HiddenNotes: Before ContractHiddenRental ContractHiddenStart Date - Contract(Required) MM slash DD slash YYYY HiddenEnd Date - Contract(Required) MM slash DD slash YYYY HiddenRental Days - Contract# of days rented forHiddenMachine Type(Required) 20' Manifold 30' Manifold 40' Manifold 16' Refractory 19' Refractory 23' Refractory 27' Refractory 30' Refractory Rental Fee(Required)Exclusive of options, taxes, and deposit fee HiddenPickup or Deliver: Contract(Required) Customer will pickup and return machine Customer will pickup, Burn Debris will return Burn Debris will deliver, Customer will return Burn Debris will deliver and return machine Estimated Delivery FeeBurn Debris will deliver machine to job site. Estimated Return FeeBurn Debris will return machine from job site. HiddenAdditional Fees ListAdditional Fees TotalDescribed above Rental Service FeeAfter you sign this contract, you'll receive an email asking you to pay a $395 service fee to reserve your machine. Price: Grand Total HiddenBilling Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code HiddenChoose Contract Standard Contract Additional Contract Conditions HiddenAdditional Contract ConditionsHiddenContract Status(Required) Not Ready To Send Call Customer Send Contract To Customer Canceled HiddenCustomer CommentsOptional. Add anything you need us to know.HiddenContract AgreementPlease check the Consent box to accept this contract and enter your name below.HiddenConsent(Required)I agree and understand that by checking this box I accept the Rental Terms & Agreement with Burn Debris LLC displayed herein and that checking this box is the legal equivalent of my handwritten signature with the name I enter below. I accept Rental Terms & Agreement with Burn Debris LLCHiddenName: Electronic Signature(Required) First Last HiddenContract Date(Required) Month Day Year HiddenContract Form Entry IDThe Entry ID of the separate contract form for this rental HiddenRental DetailsStaff assigns a specific machine, enters actual pickup and actual return date.HiddenMachine(Required) Dryall M25-1 M30-4 M30-5 M30-6 M30-7 M40-1 HiddenExpected Pickup Date MM slash DD slash YYYY HiddenActual Pickup Dateor delivered MM slash DD slash YYYY HiddenExpected Return Date MM slash DD slash YYYY HiddenActual Return Date MM slash DD slash YYYY HiddenActual Rental DaysBased on when machine was picked up and returned and not the contract datesActual Rental Fee HiddenCustomer OwesActual Rental Fee Minus Contract Rental Fee Paid. If negative, customer overpaid.HiddenBefore Photo Date MM slash DD slash YYYY HiddenAfter Photo Date MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.