Form CAD-160 "Equipment Rental Request" - Mississippi

What Is Form CAD-160?

This is a legal form that was released by the Mississippi Department of Transportation - a government authority operating within Mississippi. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2016;
  • The latest edition provided by the Mississippi Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CAD-160 by clicking the link below or browse more documents and templates provided by the Mississippi Department of Transportation.

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Download Form CAD-160 "Equipment Rental Request" - Mississippi

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MISSISSIPPI DEPARTMENT OF TRANSPORTATION
CAD-160
Rev. 12-2016
EQUIPMENT RENTAL REQUEST
Date:
Mississippi Department of Transportation
Rental No.:
______________________________
Jackson, MS.
Project No.:
______________________________
Gentlemen:
County
This is our formal request that you approve our rental of equipment specifically designated from
Name of Lessor
Address City, State ZIP
Federal Tax ID Number
Phone
for use on the above project. We advise and affirm that there is not a side agreement or mutual understanding between
, prime (sub) contractor and
,
lessor, whereby
we are
required to pay any bonus, premium, stipend, stipulation, gratuity, or extra compensation of any nature whatsoever, in addition to
the agreed rental price or prices for equipment being rented and used in construction of the above mentioned project. In
addition, there does not exist a bond between
, prime (sub)
contractor, and
, lessor.
A schedule of the
equipment, rental rates, indicating with or without, as applicable, labor used in the operation of the equipment, and the
anticipated duration of use expressed in units of time (hours, days, weeks or months) are as follows:
SCHEDULE (Attach additional sheet if needed)
Equipment Make & VIN
Cost per
Number
Model
Year
Duration
Unit of Time
Operator
We further certify that the rental prices shown without operators are reasonable for the units of equipment being rented
and that any rental prices shown with operators are reasonable and include an amount for payment of labor used in the operation
of such equipment by ______________________________________________, lessor, at the effective rates shown in the
contract.
:
By
Signature (MDOT Project Engineer)
Prime Contractor
:
Date Approved:
By
Signature
Approved Original to Contract Administration Director
Submit:
Title
Pc:
Construction Engineer
District Engineer
Notary Public
Project Engineer
Prime Contractor
Central File
(Seal)
MISSISSIPPI DEPARTMENT OF TRANSPORTATION
CAD-160
Rev. 12-2016
EQUIPMENT RENTAL REQUEST
Date:
Mississippi Department of Transportation
Rental No.:
______________________________
Jackson, MS.
Project No.:
______________________________
Gentlemen:
County
This is our formal request that you approve our rental of equipment specifically designated from
Name of Lessor
Address City, State ZIP
Federal Tax ID Number
Phone
for use on the above project. We advise and affirm that there is not a side agreement or mutual understanding between
, prime (sub) contractor and
,
lessor, whereby
we are
required to pay any bonus, premium, stipend, stipulation, gratuity, or extra compensation of any nature whatsoever, in addition to
the agreed rental price or prices for equipment being rented and used in construction of the above mentioned project. In
addition, there does not exist a bond between
, prime (sub)
contractor, and
, lessor.
A schedule of the
equipment, rental rates, indicating with or without, as applicable, labor used in the operation of the equipment, and the
anticipated duration of use expressed in units of time (hours, days, weeks or months) are as follows:
SCHEDULE (Attach additional sheet if needed)
Equipment Make & VIN
Cost per
Number
Model
Year
Duration
Unit of Time
Operator
We further certify that the rental prices shown without operators are reasonable for the units of equipment being rented
and that any rental prices shown with operators are reasonable and include an amount for payment of labor used in the operation
of such equipment by ______________________________________________, lessor, at the effective rates shown in the
contract.
:
By
Signature (MDOT Project Engineer)
Prime Contractor
:
Date Approved:
By
Signature
Approved Original to Contract Administration Director
Submit:
Title
Pc:
Construction Engineer
District Engineer
Notary Public
Project Engineer
Prime Contractor
Central File
(Seal)