KleenMark Distribution
Equipment Rental Quote Request

Email*

First name*

Last name*

Company name*

Phone number*

Mobile phone number*

Street address*

Equipment Name*

Select all that apply.

20" Auto Scrubber

26" Auto Scrubber

Air Mover

I-Mop Auto Scrubber

Spotter

SSS Extractor

Swing Machine

Wet/Dry Vac

Reserved by:

Name of person making the reservation, if different than above.

Will equipment be picked up at KleenMark OR delivered to a specific locale?*

Please indicate if the equipment will be picked up OR if it needs to be delivered.

Yes, I will PICK-UP equipment.

Yes, DELIVER equipment to my location.

Rental pick-up date:

Month/Day/Year

Rental return date:

Month/Day/Year

Name of person picking up the equipment.

Best contact number for pick-up contact:

I acknowledge that a credit card is required at the time of pick-up/drop-off.*

Yes, I acknowledge a credit card is required.