• Copy of ID Document or Drivers Licence
  • Proof of Residence
  • Deposit (Cash or Card)



(“Coastal Hire”)
PELSHALL TRADING cc t/a Coastal Hire Pinetown
Reg No. 2000/001889/23
VAT No. 4950187585
P.O.BOX 1802, PINETOWN, 3600
TEL: 031 702 3506
FAX: 031 702 7190


Name (required) ("the Customer")

ID No (required)

Full Postal Address (required)

Residential Address (required)

Telephone No (required)

Cellphone No (required)

Facsimile No

Email 1 (required)

Email 2

Email 3

Email For Accounts

Email For Buyer

Vehicle Registration Number

Bank (required)

Branch Number (required)

Branch Code (required)

Account Number (required)


Employer Name

Employer Telephone Number

Employer Address

Position Held

Closest Relative Not Living With You:

Name (required)

Telephone Number (required)

Cell Number


Name And Telephone Of Trade References:

Name 1 (required)

Telephone Number 1 (required)

Name 2 (required)

Telephone Number 2 (required)

Name 3 (required)

Telephone Number 3 (required)

I have read the Terms and Conditions below (required)

Terms and Conditions

  1. I warrant that the information above is true and correct and that any false information given may result in criminal action being instituted against me. Any order, request and/or hire between me and Coastal Hire will be subject to the terms and conditions contained in this application, which I have read and understood.
  2. This is not a credit application. All amounts payable are due upon return of the equipment. Unless otherwise indicated all rates are charged per day at Coastal Hire’s ruling hire rate.
  3. Although this is a cash application. I consent and agree that this information may be used by Coastal Hire for the purpose of assessing the hire risk, that Coastal Hire or its representative may contact and request any material information from any person, credit bureau or business, and consent to and authorise Coastal Hire to furnish personal and credit information concerning my dealings with Coastal Hire to any credit bureau and to any third party seeking a trade reference.
    I understand that:
    Coastal Hire is a rental business that provides equipment to its customers as per the customer’s specific request. Any advice given to me regarding the suitability of the equipment for any specific use, is given purely on the basis of the information provided by me.
    Written instructions regarding the specifications and use of the equipment are available from Coastal Hire and I undertake to ensure that the equipment is only used in accordance with these instructions.
    Only the specified fuel mixtures and additives may be used in the equipment and oil and lubricant levels must be maintained at all times. If the incorrect fuel mixture or additives are used or if the oil and lubricant levels are not maintained, I will be liable for any damage caused as a result and Coastal Hire will be entitled to claim for such damage in terms of Clause 12.
    Air filters are not to be removed from equipment.
    I acknowledge that the equipment hired predominatly comprises of moving parts and of its very nature may cause serious injury or death if not correctly used. It is therefore imperative that the operation manual, specic instructions or guide as provided for by the manufacturer or Coastal Hire be strictly followed
  6. If the equipment is to be delivered by Coastal Hire, Coastal Hire will not be responsible for any loss or damages suffered by me as a result of non-delivery of equipment or part delivery thereof or delays in delivery for whatsoever reason, and time shall not be of the essence in respect of any order.
  7. Coastal Hire and I choose our street addresses as stated on this Application for HIre Facilities as the address for the purpose of serving summons and any other legal notices which require personal service levying execution arising out of this agreement ( “domicilium citandi et executandi”)
  8. The ownership in the equipment hired or if purchased, not fully paid for, in terms of this agreement shall remain vested in Coastal Hire, or any cessionary to whom Coastal Hire may cede its rights. i undertake at all material times to inform Coastal Hire of the address at which the equipment is to be used and stored and to inform the owner of such premises at to the ownership of the equipment. I will ensure that the equipment is not attached by any third party for any reason whatsoever and undertake to inform Coastal Hire immediately in the event of any form of attachment being exercised, or any attempt to exercise any form of attachment, against the equipment.
  9. No relaxation by Coastal Hire, of the strict terms of this Agreement and no indulgence which Coastal Hire may grant to me in exercising any right which Coastal Hire has, shall in any way prejudice Coastal Hire’s rights. If Coastal Hire does allow any relaxation or indulgence, this will not be regarded as a waiver of by Coastal Hire of any right or as a novation of this agreement.
  10. (a)The deposit is based upon the value of the equipment hired and is payable at the time of hire . This deposit will be set off against any amounts due on return of the equipment. Where equipment is hired for a period in excess of 5 days, Coastal Hire may require further deposits during the hire period.
    (b) On return of the equipment, any shortfall for the hire is payable immediately against invoice.
    (a) Risk in the equipment will pass to me when the equipment leaves Coastal Hire’s premises or, if the equipment is delivered by Coastal Hire, at the place and time of delivery. The person accepting the equipment on my behalf confirms that he has inspected the equipment and acknowledges that it appears to be in good condition and working order. Signature by me or on my behalf of Coastal Hire’s delivery or hire note and/or invoice, shall be regarded as acceptance by the Customer that the equipment described in such delivery or hire note and/or invoice has been properly and completely delivered.
    (b) Equipment will only be deemed to have been returned to Coastal Hire when Coastal Hire provides me or my representative with a document signed with the full signature of a representative of Coastal Hire, which records the return of such equipment (an off hire note, tax invoice or similar document). I undertake to return the equipment to the Coastal Hire premises on the agreed return date as per the hire note. I acknowledge that rental charges are calculated on a 24 hour cycle and unless the equipment is returned by no later than the time at which it was hired out, I will be liable for a further day’s rental.
    (c) Where Coastal Hire delivers the equipment, I will be liable for delivery fees at the ruling rate at the date of delivery.
    I am responsible for insuring the equipment and I accept full responsibility for any loss of or damage to the Equipment during the hire period.
    The cost of reinstating the equipment to its pre-delivery condition will be for my account and will be payable upon invoice by Coastal Hire. I will remain liable for the agreed hire rates until such equipment has been re-instated to its pre-delivery condition.
    If the equipment is damaged beyond repair or stolen, lost or misplaced or not returned for any reason, I agree to compensate Coastal Hire at the full retail price of such equipment. I will remain liable for the agreed hire rates until such time as I have made payment of the full retail price.
    Coastal Hire is entitled to charge interest, from due date until date of payment, at the maximum interest rate allowed in terms of the National Credit Act, 2005, or any other applicable legislation which may replace the relevant provisions of the National Credit Act, on any amount arising out of this Agreement and not paid on or before due date.
    I consent to the jurisdiction of the Magistrate’s Court having jurisdiction over the Customer in respect of any action which might be instituted arising from this Agreement, irrespective of the amounts claimed or the value of the equipment involved in such action. Both Coastal Hire and I shall however retain the right to institute proceedings in any other Court having jurisdiction in the matter.