UGo Mobility Liability Agreement

Agreement: In consideration of the payment of a fee and the signing of the Agreement, I, the Individual listed in the rental agreement, do hereby agree to rent from U-Go Mobility the personal mobility aide as outlined in the attached rental agreement.

Renter’s Information:

Renter’s Name: _______________________________________

Is rider’s weight over 300 lbs.? Yes / No

Equipment: The rented equipment is _______________________________________.

Use of and Damage to Rental Equipment: I acknowledge that I will / have received instructions on the correct use of the equipment and I agree to return the equipment in the same condition as which it was rented to me. I agree to pay for any damage and authorize UGo Mobility to charge my credit card for any and all damage up to the full replacement cost of the equipment. Proof of replacement parts’ cost or unit cost will be provided to me. If the scooter or equipment I receive is damaged in any way upon delivery and acceptance by me I will inform Ugo Mobility.

Accident / Medical Coverage: Should emergency medical treatment be required, I and/or my own accident/medical insurance shall pay for all such incurred expenses.

Agreement Scope and Definitions: This agreement shall be legally binding upon me, the registered renter and my heirs, estate, assigns, including all minor children, and personal representative, and it shall be interpreted according to the laws of the State of Hawaii. If any clause, phrase, or word is in conflict with the laws of the State of Hawaii then only that single part is null and void. The phrase “Personal Mobility Aid” shall include battery-operated scooters, wheelchairs, and walkers/rollators.

Arbitration: Any dispute, controversy, or claim arising out of the Agreement shall be finally settled by binding arbitration as set forth in this Section. Three independent, neutral arbitrators appointed in accordance with the Commercial Arbitration Rules of American Arbitration Association shall conduct the arbitration. The arbitration shall be held in Hawaii. The arbitrators shall determine what discovery, provided that the arbitrators shall permit such discovery, as they deem necessary or useful to permit an equitable and informed resolution of the dispute. Any written evidence originally in a language other than English shall be submitted in English translation accompanied by the original or a true copy thereof. The decision or award rendered by the arbitrator shall be written (specifically stating the arbitrator’s findings of facts, as well as the reasons upon which the arbitrator’s decision is based), final and non-appealable (except for an alleged act of corruption or fraud on the part of the arbitrator) and may be entered in any court of competent jurisdiction for a judicial recognition of the decision and an order of enforcement.

Liability Release: I AGREE THAT: In consideration of UGo Mobility rental of durable medical equipment and battery-operated mobility devices, under the terms set forth, herein, I, for myself and legal ward, heirs, administrators, personal representative or assigns do agree to hold harmless, release and discharge UGo Mobility, their owners, agents, employees, officers, directors, representatives, assigns, members, owners of premises, affiliated hotels or organisations, insurers and other acting on their behalf (hereinafter collectively referred to as “associates”), of and from all claims, demands, causes of action and legal liability, whether the same be known or unknown, anticipated or unanticipated, due to UGo Mobility and their associates gross negligence and willful and wanton misconduct. I shall not bring claim, demands, legal actions, or causes of action against UGo Mobility and their associates as stated above in the clause, for any economic and non-economic losses due to bodily injury, death and / or property damage sustained by me and /or my legal ward in relation to the premises and operation of UGo Mobility to include while riding and /or operating a Personal Mobility Aid in Hawaii.

Reservations: We recommend making reservations as early as possible to ensure the availability of the desired equipment, as we have a first come first serve policy. We cannot guarantee the availability of specific models or types of equipment.

Rental Delivery and Returns: All deliveries are made between 12pm-5pm unless otherwise specified. All pick-ups should be ready by 10:00am on day of departure, unless previous arrangements have been made. If you decide to extend your rental, you must notify UGo Mobility 24 hours prior to return date. Failure to do so will result in an additional service charge of $30.00 plus all additional rent for the extended period.

Damages: Renter is fully responsible for the loss, theft or destruction of said property from all causes and agrees to pay the owner the fair market value of the property in such event. In the event of damage and/or partial destruction from any cause, renter agrees to pay to the owner a reasonable cost of repair to said property.

Cancellation Policy: All cancellations made prior to 48 hours will be charged a one-time fee of $25. Cancellations placed within 48 hours of scheduled delivery will be charged for one full day of the full reservation amount.

Last-Minute Bookings: Bookings made within 48 hours of arrival are subject to a fee of $50.00.

Signature: I, the individual named in the rental contract, hereby consent to rent the personal mobility aid specified in the attached rental contract from UGo Mobility, in exchange for a fee. My signature on this agreement implies I have read and understood the above Agreement, release, and the assumption of risk.

SIGNER STATEMENT OF AWARENESS

I/We, the undersigned, have read and do understand the foregoing Agreement, release and assumption risk.

Signature __________________________________________ Date  _________________________________

Address ____________________________________________________________________________________

Phone: ___________________________________