Rental Agreement

#4206
Completed

4019 NW 28th ST Miami FL 33142

Renter Information Rental Information

Dayri Dominguez - D552160866400 Date Out 11/21/2022 5:18 PM

Date Due 12/12/2022 1:36 PM
04/20/1986
DAYRITITI@GMAIL.COM, +1 7862820510 Extensions
10952 SW 71ST, Miami, United States 1 12/12/2022 5:00 PM

Insurance Information: Pickup Location 4019 NW 28th St 33142 Miami FL

Insurance company: Return Location 4019 NW 28th St 33142 Miami FL
Policy number:
Policy type:
Effective date:

Signature Charge Information

THE VALID AND COLLECTIBLE LIABILITY INSURANCE AND PERSONAL INJURY PROTECTION INSURANCE OF ANY AUTHORIZED Time Charges
RENTAL OR LEASING DRIVER IS PRIMARY FOR THE LIMITS OF LIABILITY AND PERSONAL INJURY PROTECTION COVERAGE 21x Days: $13.80 $289.80
REQUIRED BY SECTIONS 3240217 AND 627.736, FLORIDA STATUTES.
Failure to return rented property or equipment upon expiration of the rental period and failure to pay all amounts due (including costs
for damage to the property or equipment) are prima facie evidence of intent to defraud, punishable in accordance with section
812.155, Florida Statutes. $289.80

SunPass $15.00 Day $315.00

Activation
Energy Recovery $1.00 $1.00
Rental Politics
Fee
If you remove the SunPass sticker the fine is $350 Florida State $2.05 $2.05
Surcharge
I'm a cigarette-free car License Recovery $1.90 $1.90
Fee
I understand the CDW doesn't cover tires, horns, and any type of windows. Miami Airport Fee $4.00 $4.00
Vehicle License $1.03 $1.03
The CDW does not cover burns, heavily soiled or damaged seats or carpets, lost or damage keys acts of vandalism or other intentional Fee
acts Sunpass use $18.00 $18.00

Basic Insurance $10.00 Day $210.00

**THE VEHICLE MAY BE DRIVEN OR USED ONLY IN THE STATE OF FLORIDA**
($3000 Deductible)
I agree that the rented vehicle will not leave the state of Florida Any renter who takes the rental vehicle outside the state will be charged a $
1000.00 out of state fee
Subtotal $842.78

Sales Tax 7.00% $44.29

OUR RENTAL VEHICLES CANNOT BE USED FOR UBER AND OR LYFT
Total Charges $887.07
COLLISION DAMAGE WAIVER (CDW)
x_ By Initialing here you agree to purchase our Basic Insurance ($3000 Deductible). It does not cover all instances of damage to the Vehicle. Cash $500.47
Credit Card $375.00
There are exclusions. Subject to the terms of Paragraph 5 on the reverse, your responsibility for Physical Damage to the Vehicle is limited to the
Credit Card $11.60
deductible amount mentioned before.
Security Deposit - Credit Card (Security Deposit)$200.00

VISITOR MAP, THIS IS TO ACKNOWLEDGE THAT I HAVE: Credit Card -$188.40

Received the Visitor information Map: Waived the Right to Receive Visitor information Map
Amount Outstanding: $0.00
An extra hour after due time has a $20 cost each

Missing Key: $350 Vehicle Information

There are no money returns if you return before the due date
know can't smoke inside of the car. An up to $400 fee will be charged if the car is returned smoked or Dirty (anything that Unit#: FD25 QJZF27 Active
requires special cleaning)
I authorize Fly n Drive Miami to charge my credit card on file for any ticket, parking ticket, toll use, toll violation, decals, towing Brand Model: Toyota Corolla
expenses plus an administrative fee of $30 for each ticket processed by Fly n Drive Miami for payment or responsibility transfer Vehicle Class: Midsize
Class: 3 Midsize
A 50$ fee will be charged for any missing gas in addition to the amount required to completely fill up the gas tank. Odom Out: 55968
Odom In: 56721
***ABSOLUTELY NO DRIVERS UNDER 21 YEARS OF AGE** Fuel Out: 8 / 8
By signing below, you agree to all the terms and conditions of this Agreement, and you acknowledge that you have been given an opportunity Fuel In: 8 / 8
to read it before being asked to sign. Your signature below allows us to process a separate credit/debit card voucher in your name for all Vin: JTDEPMAEXMJ163595
amounts due to us. You permit us to reserve against your card at the beginning of the rental a reasonable amount in addition to the estimated License Plate: QJZF27
charges. You also authorize us to charge your credit/debit card after the rental concludes for any unpaid parking, toll violations or other fines or
penalties assessed against you, us or the Vehicle during this rental

Signature

Signed at 11/21/2022 5:20 PM.