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Need rental equipment for a short term project or while your pump is in for service and you want to avoid purchasing new equipment? The PumpWorks rents Vacuum pumps, Helium Leak Detectors etc... You can easily setup an equipment rental at your convenience; simply fill out our rental request form.

We will email, fax, or phone you with a rental cost and PRN number (Pump Rental Number) this allows us to track the rental equipment from start to finish. We will schedule the rental shipment only after your acceptance, and return of our rental agreement form from your company. Please feel free to call us at 800-975-7867 USA only or fill out the form below, we look forward to talking with you.

Note: If you are sending equipment in for service please fill out our shipment Notification form.

Please fill in the boxes below, we will quote you the rental cost based on the information provided, if you have any questions about this form or equipment rental please contact customer service at cs@thepumpworks.com or call 1-800-975-7867 USA only.

Fields marked with asterisk ( * ) are mandatory.

	Company Name
	Contact Name*

Pickup Details


	Address
	City
	State
	Zip Code

Return Details


	Address
	City
	State
	Zip Code

Other Details

Telephone Number*

Ext.*

Fax Number

E-mail Address*

Date Equipment will be ready for pickup

(mm/dd/yyyy)

P.O. Number

Equipment Information


	Type equipment requested for Rental


	Brand*
	Model*
	Type
	CFM Range
	ETC.
	Motor Voltage
	Fluid Type
	Application or process equipment is to be used on