Credit Card Authorization - Repairs

Credit Card Authorization - Repairs

If you prefer not to put your credit card information in this form, please fill out the other fields and write "CALL FOR INFO" in the 'Card Number' field.

In filling out this form, you authorize West County Equipment Rentals to charge your credit card for payment of goods or services.


This payment authorization is for the goods and/or services described above. I certify that I am an authorized user of this credit card- and will not dispute the payment with my credit company; so long as the transaction corresponds to the terms indicated in the above form.

Please review what you entered before you click the Submit button, and click it ONLY ONCE.