1 Thank you for your interest in joining the LiteGear family! In order to set up your LiteGear Account, return the following items. Please note, that it may take up to 24 hours to process and verify all of the submitted documents. 1. Account Reference Form -- Filled Out & Signed 2. Certificate of Insurance (COI) LiteGear must receive and verify the COI before the gear can be released. The COI must contain the following provisions:* 1. Commercial General Liability Each Occurrence Limit of $1,000,000 General Aggregate of $2,000,000 2. Third Party Property Damage (Property/Inland Marine) Minimum Limit of $1,000,000 3. LiteGear, Inc. 4406 Vanowen St Burbank, CA 91505 Should be added as additional insured with respects to the Commercial General Liability and Loss Payee with respects to the Property/Inland Marine. *A sample COI is attached for your reference. The name and address on the account application must match the name and address in the Insured section of your provided COI. The following documents are for your records: 1. LiteGear s Rental Terms and Conditions 2. LiteGear s W9 Payment Information: 1. LiteGear s Credit Card Authorization Form If you are paying with a credit card, we will also require a photo copy of the front and back of the credit card as well a photo copy of your photo ID. 2. LiteGear s Wire Transfer Information If you are an international customer that would prefer to pay by Wire. 3. LiteGear s PayPal Information: info@litegear.com If you are a domestic or international customer that would prefer to pay through PayPal. Notes: For international payments we only accept payments sent by Wire or PayPal. Unfortunately, we cannot accept any foreign checks. Services Fees may apply to Credit Card, PayPal, and Wire payments. 4406 Vanowen St., Burbank, CA 91505 P. +1 (818) 358-8542 F. +1 (818) 475-1657 info@litegear.com litegear.com
2 Customer Profile Company/Individual Name: Address: City: State: Zip Code: Country: New Account Credit Reference Form Please fill this form out completely Buyer Name: Accounting Contact: Title: Title: If you are a company/production applying for Net 30 Terms, please fill out the additional fields. Credit One Sheets are acceptable if all information is included. Company/Production Information Federal Tax ID # or SSN: State of Incorporation: Type of Business: Proprietorship Partnership Corporation LLC Resale Number: Bank Information Bank Name: Bank Phone: (Please attach resale form) Bank Contact: Account Number: City: State: Zip Code: - Continued on page 2-4406 Vanowen St., Burbank, CA 91505 P. +1 (818) 358-8542 F. +1 (818) 475-1657 info@litegear.com litegear.com
3 Trade Reference #2 Company Name: Contact: Address: New Account Credit Reference Form Please fill this form out completely - Continued from page 1 - Trade References Please list 3 industry related references (such as rental houses, post production, misc. vendors etc.) Trade Reference #1 Company Name: Contact: Address: Fax: Website: City: State: Zip Code: Country: Fax: Website: City: State: Zip Code: Country: Trade Reference #3 Company Name: Contact: Address: Fax: Website: City: State: Zip Code: Country: I authorize the above information is true and correct and that LiteGear, Inc., is allowed to contact our bank and references to determine payment terms for our company. Sign: Print: Date: 4406 Vanowen St., Burbank, CA 91505 P. +1 (818) 358-8542 F. +1 (818) 475-1657 info@litegear.com litegear.com
BOE-230 (7-02) GENERAL RESALE CERTIFICATE STATE OF CALIFORNIA BOARD OF EQUALIZATION California Resale Certificate I HEREBY CERTIFY: 1. I hold valid seller s permit number: 2. I am engaged in the business of selling the following type of tangible personal property: 3. This certificate is for the purchase from LiteGear, Inc., DBA: LiteGear of the item(s) I have listed in paragraph 5 below. [Vendor s name] 4. I will resell the item(s) listed in paragraph 5, which I am purchasing under this resale certificate in the form of tangible personal property in the regular course of my business operations, and I will do so prior to making any use of the item(s) other than demonstration and display while holding the item(s) for sale in the regular course of my business. I understand that if I use the item(s) purchased under this certificate in any manner other than as just described, I will owe use tax based on each item s purchase price or as otherwise provided by law. 5. Description of property to be purchased for resale: 6. I have read and understand the following: For Your Information: A person may be guilty of a misdemeanor under Revenue and Taxation Code section 6094.5 if the purchaser knows at the time of purchase that he or she will not resell the purchased item prior to any use (other than retention, demonstration, or display while holding it for resale) and he or she furnishes a resale certificate to avoid payment to the seller of an amount as tax. Additionally, a person misusing a resale certificate for personal gain or to evade the payment of tax is liable, for each purchase, for the tax that would have been due, plus a penalty of 10 percent of the tax or $500, whichever is more. NAME OF PURCHASER SIGNATURE OF PURCHASER, PURCHASER S EMPLOYEE OR AUTHORIZED REPRESENTATIVE PRINTED NAME OF PERSON SIGNING TITLE ADDRESS OF PURCHASER TELEPHONE NUMBER ( ) DATE
4 SPECIALTY LIGHTING GEAR FOR FILM, TV, AND EVENTS. 4406 VANOWEN STREET BURBANK, CA 91505 PH: +1(818) 358-8542 FX: +1(818) 475-1657 RENTAL AGREEMENT LiteGear, Inc. Terms & Conditions I. THE UNDERSIGNED AGREES TO TEST ALL EQUIPMENT RENTED OR PURCHASED FROM LITEGEAR, INC. (HEREINAFTER REFERRED TO AS THE EQUIPMENT ) PRIOR TO RENTAL OR SALE. ACCEPTANCE OF THE EQUIPMENT AND REMOVAL FROM LITEGEAR, INC. S PREMISES SHALL CONSTITUTE THE UNDERSIGNED S AGREEMENT THAT THE EQUIPMENT IS IN GOOD WORKING ORDER AND FREE OF DEFECTS. 2. LITEGEAR, INC. MAKES NO WARRANTIES WITH RESPECT TO THE CONDITION OF THE EQUIPMENT OR ITS FITNESS FOR THE INTENDED USES OF THE UNDERSIGNED. LITEGEAR, INC. SHALL BE RESPONSIBLE TO REPLACE ANY EQUIPMENT WHICH SHALL NOT FUNCTION PROPERLY, BUT LITEGEAR, INC. SHALL NOT, IN ANY OTHER WAY, BE LIABLE TO THE UNDERSIGNED OR ANY THIRD PARTY FOR ANY LOSS OR DAMAGE, INCLUDING BUT NOT LIMITED TO CONSEQUENTIAL DAMAGES, RESULTING FROM ANY FAILURE OF THE EQUIPMENT. 3. THE UNDERSIGNED SHALL BE SOLELY RESPONSIBLE TO MAINTAIN THE EQUIPMENT DURING ANY RENTAL TERM, AND SHALL KEEP ANY RENTED EQUIPMENT IN ITS CUSTODY AT THE LOCATION OR LOCATIONS PROVIDED TO LITEGEAR, INC. AT THE TIME OF RENTAL. SHOULD THE EQUIPMENT BE DAMAGED WHILE IN THE POSSESSION OF THE UNDERSIGNED, THE UNDERSIGNED AGREES TO PAY LITEGEAR, INC. FOR ALL COSTS OF REPLACEMENT OR REPAIR OF THE EQUIPMENT AS WELL AS TO REIMBURSE LITEGEAR, INC. FOR ANY LOST RENTAL INCOME FROM THE EQUIPMENT. TO THIS END, THE UNDERSIGNED SHALL MAINTAIN INSURANCE COVERAGE ON ALL THE RENTED EQUIPMENT IN AN AMOUNT SUFFICIENT TO THE LOSS OR DESTRUCTION OF SUCH EQUIPMENT. SAID INSURANCE SHALL NAME LITEGEAR, INC. AS AN ADDITIONAL LOSS PAYEE. THE UNDERSIGNED SHALL PROVIDE LITEGEAR, INC. A COPY OF SAID INSURANCE UPON TAKING POSSESSION OF THE EQUIPMENT. 4. IN ADDITION TO THE INSURANCE REQUIREMENT SET FORTH ABOVE, THE UNDERSIGNED AGREES TO MAINTAIN LIABILITY INSURANCE, IN AN AMOUNT NOT LESS THAN $1,000,000.00 INSURING AGAINST ANY DAMAGE TO PERSONS OR PROPERTY WHICH MAY BE CAUSED BY THE EQUIPMENT. LITEGEAR, INC. SHALL BE NAMED AS AN ADDITIONAL INSURED ON SUCH POLICY, AND THE NAME UNDERSIGNED SHALL PROVIDE LITEGEAR, INC WITH A COPY OF THE SAME AT THE TIME OF TAKING POSSESSION OF THE EQUIPMENT. 5. THE UNDERSIGNED SHALL INFORM LITEGEAR, INC. OF THE LOCATION OR LOCATIONS THE EQUIPMENT WILL BE USED OR KEPT DURING ANY RENTAL TERM, AND THE UNDERSIGNED SHALL NOT USE OR KEEP THE EQUIPMENT AT ANY OTHER LOCATION WITHOUT PRIOR WRITTEN CONSENT OF LITEGEAR, INC. 6. THE UNDERSIGNED SHALL RETURN THE EQUIPMENT TO THE ADDRESS SPECIFIED BY LITEGEAR, INC. NOT LATER THAN THE AGREED UPON TIME AND DATE. THE COST OF RETURN SHALL BE BORNE BY THE UNDERSIGNED. SHOULD THE EQUIPMENT BE RETURNED AFTER THE AGREED UPON TIME AND DATE, THERE SHALL BE A LATE CHARGE EQUAL TO THE DAILY RATE (PER DAY) OF THE SAID EQUIPMENT. 7. THE RENTAL OR PURCHASE PRICE OF THE EQUIPMENT SHALL BE SET FORTH IN THE APPROPRIATE RENTAL FORM OR SALES FORM ATTACHED HERETO, AND SHALL BE PAID IN ADVANCE. THERE SHALL BE NO REFUND OR DISCOUNT OF RENTAL FOR EARLY RETURN OF RENTED EQUIPMENT UNLESS AGREED FIVE WORKING DAYS PRIOR AND APPROVED BY LITEGEAR, INC. 8. THE UNDERSIGNED SHALL DEPOSIT WITH LITEGEAR, INC. PRIOR TO TAKING POSSESSION OF ANY RENTED EQUIPMENT, A SECURITY DEPOSIT, IN THE AMOUNT SET FORTH IN THE APPROPRIATE RENTAL FORM. SAID SECURITY DEPOSIT SHALL BE RETAINED BY LITEGEAR, INC. TO COVER ANY DAMAGE TO THE EQUIPMENT, LATE CHARGES, OR OTHER COSTS OR EXPENSES OF LITEGEAR, INC. FOR WHICH THE UNDERSIGNED SHALL BE RESPONSIBLE. LITEGEAR, INC. SHALL RETURN TO THE UNDERSIGNED ANY OF THE UNUSED PORTION OF THE SECURITY DEPOSIT WITHIN TEN WORKING DAYS OF THE RETURNED EQUIPMENT. LITEGEAR, INC. SHALL HAVE NO OBLIGATION TO PAY ANY INTEREST ON ANY PORTION OF ANY SECURITY DEPOSIT. 9. THE UNDERSIGNED AGREES NOT TO TRANSPORT ANY RENTED EQUIPMENT BY ANY AIRCRAFT WITHOUT THE PRIOR WRITTEN CONSENT OF LITEGEAR, INC. 10. LITEGEAR, INC. SHALL HAVE THE RIGHT TO INSPECT ANY RENTED EQUIPMENT AT THE LOCATION THAT IT IS KEPT AT ALL REASONABLE TIMES. 11. THE UNDERSIGNED SHALL NOT SUBLEASE ANY RENTED EQUIPMENT, ASSIGN THE UNDERSIGNED S RIGHTS UNDER THIS AGREEMENT TO ANY THIRD PARTY, OR LOAN ANY RENTED EQUIPMENT TO ANY THIRD PARTY WITHOUT THE PRIOR WRITTEN CONSENT OF LITEGEAR, INC. 12. THE UNDERSIGNED SHALL NOT REMOVE THE NAMEPLATE(S), TAG(S), OR LABEL(S) SHOWING LITEGEAR, INC. S OWNERSHIP OF ANY RENTED EQUIPMENT. 13. LITEGEAR, INC. S ACCEPTANCE OF RETURNED RENTAL EQUIPMENT DOES NOT CONSTITUTE A WAIVER OF ANY OF LITEGEAR, INC. S RIGHTS REGARDING REIMBURSEMENT FOR DAMAGED EQUIPMENT OR LATE CHARGES, OR ANY OTHER SUMS TO WHICH LITEGEAR, INC. MAY BE ENTITLED, WHICH RIGHTS MAY BE EXERCISED AFTER SAID ACCEPTANCE. 14. IF THE UNDERSIGNED IS A PERSON, HE/SHE DECLARES THAT HE SHE IS AT LEAST TWENTY ONE YEARS OF AGE. 15. IF THE UNDERSIGNED SHALL BREACH ANY OF THE TERMS OF THE AGREEMENT OR IF ANY PROCEEDING IN BANKRUPTCY OR INSOLVENCY COVERING THE UNDERSIGNED IS COMMENCED, OR IF A RECEIVER SHALL BE APPOINTED FOR THE UNDERSIGNED, OR IF RECEIVERSHIP PROCEEDINGS GOVERNING THE UNDERSIGNED ARE COMMENCED, LITEGEAR, INC. MAY IMMEDIATELY TAKE POSSESSION OF ANY RENTED EQUIPMENT. SAID TAKING OF THE POSSESSION MAY INCLUDE ENTERING ON THE PREMISES WHERE THE EQUIPMENT IS LOCATED, WITHOUT NOTICE OF INTENTION TO DO SO OR WITHOUT MAKING A PRIOR DEMAND FOR POSSESSION. THE UNDERSIGNED SHALL BE LIABLE TO LITEGEAR, INC. FOR LITEGEAR, INC. S COSTS AND EXPENSES OF SUCH TAKING OF POSSESSIONS. LITEGEAR, INC. SHALL NOT BE LIABLE TO THE UNDERSIGNED WITH RESPECT TO LITEGEAR, INC. S ACTIONS TAKEN IN CONNECTION WITH SUCH TAKING OF POSSESSION, INCLUDING, BUT NOT LIMITED TO, ANY LOSSES THE UNDERSIGNED MAY INCUR AS A RESULT OF NOT HAVING THE FURTHER USE OF THE EQUIPMENT. SHOULD LITEGEAR, INC. TAKE POSSESSION UNDER THIS PARAGRAPH 15, THE UNDERSIGNED SHALL NOT BE ENTITLED TO ANY REFUND OF UNEARNED RENTALS. 16. LITEGEAR, INC. MAY AMEND THE TERMS OF THIS AGREEMENT, OR CANCEL THIS AGREEMENT AT ANY TIME BY PROVIDING PRIOR WRlTTEN NOTICE OF SUCH AMENDMENT OR CANCELLATION. SUCH AMENDMENT OR CANCELLATION SHALL NOT AFFECT ANY SALES OR RENTALS EFFECTED PRIOR TO THE DATE OF THE AMENDMENT OR CANCELLATION. 17. THIS AGREEMENT SHALL INSURE TO AND BE BINDING ON THE HEIRS, ASSIGNS, TRANSFEREES, AND SUCCESSORS IN INTEREST OF THE UNDERSIGNED AND LITEGEAR, INC. 18. IN THE EVENT THAT ANY ACTION IS BROUGHT FOR ANY BREACH OR DEFAULT IN ANY OF THE TERMS OF THIS AGREEMENT, LITEGEAR, INC. SHALL BE ENTITLED TO RECOVER FROM THE OTHER PARTY ALL COSTS AND EXPENSES INCURRED IN ANY SUCH ACTION OR ANY APPEAL THEREFROM, INCLUDING, WITHOUT LIMITATION, ALL ATTORNEYS FEES AND COURT COSTS ACTUALLY INCURRED REGARDLESS OF ANY OTHER APPLICABLE COURT SCHEDULED FOR THE RECOVERY THEREOF. 19. THIS AGREEMENT, ALONG WITH THE APPROPRIATE RENTAL OR SALES FORM, CONSTITUTES THE ENTIRE AGREEMENT BETWEEN THE UNDERSIGNED AND LITEGEAR, INC. PERTAINING TO THE SUBJECT MATTER THEREOF AND SUPERSEDES ALL PRIOR AGREEMENTS, UNDERSTANDINGS, NEGOTIATIONS, AND DISCUSSIONS, WHETHER VERBAL OR WRITTEN, OF THE PARTIES. NO WAIVER OF ANY OF THE PROVISIONS OF THIS AGREEMENT SHALL BE DEEMED OR SHALL CONSTITUTE A WAIVER OF ANY OTHER PROVISION HEREOF (WHETHER OR NOT SIMILAR), NOR SHALL SUCH WAIVER CONSTITUTE A CONTINUING WAIVER UNLESS OTHERWISE EXPRESSLY PROVIDED. 20. THE VALIDITY, CONSTRUCTION, AND INTERPRETATION OF THIS AGREEMENT SHALL BE GOVERNED BY THE LAWS OF THE STATE OF CALIFORNIA. Sign: Print: Date:
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT Broker/Agent Contact PRODUCER Insurance Broker/Agent for Client/Lessee Address INSURED Client/Lessee (must match name on contract and form of payment) Address NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : SAMPL PL LE LE INSURER(S) AFFORDING COVERAGE FAX (A/C, No): Insurance Company Insurance Company Insurance Company (Minimum financial rating A- VIII) COVERAGES CERTIFICATE NUMBER: ENT Equipment REVISION NUMBER: 3/28/2017 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCESWVD INSD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 123456789 01/01/2017 01/01/2018 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO 123456789 01/01/2017 01/01/2018 BODILY INJURY (Per person) $ B ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED X HIRED AUTOS X AUTOS Hired Auto Physical Damage PROPERTY DAMAGE (Per accident) $ X Hired P.D. Deductible $1,000 Hired Auto Physical Damage $ 75,000 A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE 123456789 01/01/2017/2017 01/01/2018 AGGREGATE $ 2,000,000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- C X AND EMPLOYERS' LIABILITY STATUTE ER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE 123456789 01/01/2017 017 01/01/2018 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Miscellaneous Equipment 123456789 01/01/2017 01/01/2018/2018 Deductible - $2,500 Limit- $1,000,000 A Third Party Property Damage Deductible - $2,500 Liimit- $1,000,000 NAIC # DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as Additional Insured for General Liability and Automobile Liability and as Loss Payee for equipment and/or vehicles rented to the Named Insured. Equipment coverage is written on a replacement cost basis including coverage while in transit and at any/unnamed locations. There is no warranty or exclusion in the policies related to locked, unlocked or unattended vehicles. CERTIFICATE HOLDER ACORD 25 (2014/01) INS025 (201401) LiteGear Inc. 4406 W. Vanowen St. Burbank, CA 91505 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE NOT VALID UNLESS SIGNED Ross Garner/ROSS 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
5 Credit Card Authorization Form Please fill out this form completely and attach a legible copy of the credit card (front and back) as well as your Photo ID. Buyer Name: Date: Company Name: Job Name: Order #: I authorize LiteGear, Inc. to charge on my credit card the following: Amount to be charged: Credit Card Type (Check One): Visa MC AMEX Discover Credit Card #: Exp. Date: Sec. Code: (AMEX 4 Digits on Front of Card MC/VISA 3 Digits on Back of Card) Name As It Appears on the Card: Credit Card Billing Address: City: State: Zipcode: I authorize LiteGear, Inc. to charge my credit card for payment of their products and/or services. If LiteGear, Inc. is unable to process my payment I will be responsible for an alternate payment arrangement and any resulting processing fees. Sign: Print: 4406 Vanowen St., Burbank, CA 91505 P. +1 (818) 358-8542 F. +1 (818) 475-1657 info@litegear.com litegear.com