Alternate Person Authorized to Make Decisions on this Account

Bank References

Open Account References

Account Authorization

Clear Signature
In consideration of the extension of credit to (Name Typed Above) and as an inducement to Brunson's Portable Toilets & Septic Tank Pumping to continue to extend credit to said customer, the undersigned jointly and severally, irrevocably and unconditionally guaranty the full and prompt payment of any and all sums of money as are now, or at any time hereafter may be owing to Brunson's Portable Toilets & Septic Tank Pumping by said customer, as a result of the extension of credit. By extension hereof the undersigned intend to bind their sole and separate property as well as their interest in any community property. The undersigned agree to hold Brunson's Portable Toilets & Septic Tank Pumping harmless from any loss, damage and expenses caused or arising out of default on the part of undersigned. Brunson's Portable Toilets & Septic Tank Pumping may proceed against undersigned without being required to first proceed against the company. (If your account has to be sent to collections there will be a .05% interest fee per month or 16% annual added to the debt which is allowed by TX law. There may also be a $20 service fee added to offset the cost of using our collection agency_ Our terms are NET 30...)

Damage Waiver

Frequently Asked Questions

The Damage Waiver Program Limits your (our customer's) current liability for theft, vandalism and accidental damage to the facilities we furnish. This is an option to our customers for their protection and is not part of the rental agreement. Here are some questions which are most asked:


Q. Am I protected against units damaged by fire or vandalism when I am not on the job?

A. Yes, you are protected 24 hours a day, 7 days a week.

Q. What happens if a unit is accidentally run over and demolished by equipment operated by one of my employees or myself?

A. You are protected against all accidental damage you or your employee cause. The average replacement value of a portable restroom is $600.00.

Q. What is my protection if one of my subcontractors, or material suppliers damages a unit on my job site or place of business?

A. You are protected anytime of the day or night for accidental damage as previously stated

Q What is our actual cost of your program?

A. The charge is $6.00 per month, per unit.

Q. What is my protection if a unit is discovered missing and obviously stolen from our job site/property?

A. The "Damage" Waiver does cover theft, when a police report is provided.

Q. Have other customers considered this program a worthwhile investment?

A. With today's high cost of replacing and repairing units due to vandalism, fire accidents and unforeseen circumstances, we seldom have a customer decline, In fact, many customers have already benefited from the program due to theft, fire and/or vandalism.

Q Do we have to accept this program?

A. No. You will need to sign the decline statement and return it to our office for our files. If we do not receive a signed and dated decline damage waiver, your account will automatically be charged to damage waiver fee monthly

Definition and Purpose of a Damage Waiver

A Damage Waiver is an option that is offered and accepted at the time of rental, waives or reduces the customer's responsibility for loss of, or damage to, a portable restroom unit or other rented equipment. A Damage Waiver is subject to all terms and conditions of the rental agreement and applicable laws.

if implemented, a Damage Waiver should  explain, in detail, what is covered and what is not covered.

If implemented, a Damage Waiver must indicate the additional cost to the lessee.

If implemented, a Damage Waiver must be accepted or declined by the customer as an option to the rental agreement.

If implemented, and the Damage Waiver is NOT accepted, the lessee must be aware of their responsibility to replace/repair damaged equipment.

If implemented, a Damage Waiver must be offered to ALL customers. Failure to do so might be interpreted as discrimination.

Portable sanitation companies may offer a Damage Waiver in their rental contracts throughout the United States.

As with your Service Contracts or any legal document, it is advised you have it reviewed by legal counsel.

DAMAGE WAIVER Our Damage Waiver offers protection for accidental physical damage to the portable restroom unit(s)/equipment that you rent. The coverage provides that we will waive our right to hold you responsible for minor repair or replacement cost resulting from physical damage to rented equipment caused by collision, fire, riot, civil commotion, and other similar type losses. The lessee is obligated to furnish BRUNSON PUMP SERVICE with a police report on all theft, vandalism, malicious mischief and similar type losses. The Damage Waiver does not cover damage resulting from willful neglect, misuse, abuse or mysterious disappearance of portable restroom unit(s)/equipment rented and lessee is subject to 100% repair or replacement cost. The cost of our Damage Waiver is $6 per month  for each portable restroom unit(s)/equipment rented. 100% Replace Cost of a Mfg. ("Standard", ADA Contalia_nt_, Hand wash Station, etc.). is: $600.00 Example: Mfg. "Standard" is $600.00 (this is the average cost of one unit) Mfg.: "ADA Compliant" is: $1,800.00 (this is the average cost of one ADA unit). This cost does not include transportation cost which is approximately: $60.00 Repair/Replacemcnt Cost for a Mfg. ("Standard" ADA Compliant, Hand wash Station, etc.) is: $600.00 (This is the average replacement cost for a "Standard" unit)

 Door:  $255.00    Side Panel: $102.00 

Skids:  $165.00    Vents  $25.00

Tank: $165.00    Roof: $145.00

Urinal: $38.00     Other: $0.00

(List typical damaged/replaced parts) Damage resulting from excessive graffiti is based on (list hourly wage of service tech)  (minimum of average time/hours required to clean) and/or replacement of damage section, whichever is less. Dama e waiver does not cover an 're,i lacement o locks or rods that have Lesskrokenokom unit.

BRUNSON PUMP SERVICE is exempt from any legal action taken, as a result of discriminatory, racial and/or sexual graffiti damage. It is your responsibility to immediately notify our office of any discriminatory, racial and/or sexual graffiti damage to our portable restroom units)/equipment. This unit will be replaced and or cleaned and you will be responsible for any additional service charge.

Clear Signature