Rent To Own Installation Confirmation - Customer Rent To Own Installation Confirmation - Customer Personal Info Title * Mr. Mrs. Ms. Dr. Full Name: * ID Number: * Cell Number: * Email Address: * VAT Number: Street Address: * Apartment, suite etc: City Suburb: * State / Province: * ZIP / Postal Code: Rental Info Unit Description * Agreement ACCEPTANCE CERTIFICATE The User confirms the Schedule, and the rental period and payment terms are complete, and the clauses of the Master Rental Agreement have been read and agreed prior to the signature of the Agreement. ********** The User irrevocably declares to Aqua Therma that the Solar Geyser Units described in the Master Rental Agreement has/have: a) Been delivered and installed in accordance with the Agreement; b) Been correctly recorded in the Schedule above and warrants that the particulars recorded above in relation to the Solar Geyser Unit corresponds with the Solar Geyser Unit delivered; c) Been purchased by Aqua Therma at the User’s special instance and request, and Aqua Therma is hereby indemnified against any claims that may be made against Aqua Therma, that the User may sustain arising out of or in relation to the purchase by Aqua Therma of the Solar Geyser Unit from the supplier. Consent * Yes, I agree with the privacy policy and terms and conditions. Signature * signature keyboard Clear If you are human, leave this field blank. Submit Start Over