Equipment Rental Waiver
Click to change pagination settings
Select Radio Equipment
CB_RadioBase
Base Radio for use in Shack/Trailer (Includes: Mic/110VAC Power Supply/Antenna/Mag Mount)
Quantity
CB_RadioMobile
Mobile/Road Radio for Vehicular use (Includes: Mic/Power/Seat Bracket/12V Cigarette Lighter Plug power cord/Antenna/Mag Mount)
Quantity
CB_RadioPortable
Portable/Hand Held Radio for Personal use (Includes: 1x Battery/Charger/Mic/Belt/Case)
Quantity
Page Break
Extra Equipment
Additional charges may apply
CB_ExtraBattery
Extra Batteries for Mobile/Handheld
Quantity
CB_ExtraGangcharger
Gangcharger (Charges up to 6 batteries)
Quantity
CB_ExtraISHeadset
IS Headset (Interface/Adapter)
Quantity
Any Additional Instructions
« Previous
Page Break
Order Details
Name
Company
Rig/Project
Company Contracted to
Working Area
Additional Information (Frequencies, Tones, Channel Names)
Phone
Email
Date Equipment is Required
Expected Date of Return
« Previous
Page Break
Shipping Information
CB_ShippingInformation
Same Contact Info as Order Details
Name
Phone
HFPU
Pickup at DataDrill
Address
Canada
United States
Additional Shipping Instructions
« Previous
Page Break
Billing Information
PO/Project/AFE
CB_BillingInfo
Same contact info as Order Details
Name
Company
Email Address
Phone
Address
Canada
Mexico
United States
Credit Card Number (#### #### #### ####)
Please Note: Credit Card information is used as a security Deposit similar to a Car Rental and is not billed
Credit Card Expiry (MM/YYYY)
Credit Card CVV (3 Digit Pin)
3 Digit Pin on the back of your Credit Card
I have read and understood the
Terms
and agree to be bound by them.
You must order at least 1 Item to submit the request
« Previous
Preview Submission
SUBMIT ORDER
