Platte River Implementation Funds Request no. 421

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THRIFTY KEARNEY AIRPORT EAR PO BOX 2022 keameyLd'ithrtftyne,com Open Emp.* 007 Kearney,NE 68848 (308)237-4720 Close Emp 09 NO CREDIT FOR EARLY RETURNS Customer Information Rental Expiry Information Rental Agreement Number MERRI MARTZ RA Out 0712212014 12.41 EAR 1016874 5336 SE 44TH AVE Cust No: 8001740 RA In: 07/24/2014 12.02 ORI Portland,OR 97206 DL#: 7070491 (503)704-2777 OR 08/25/2016 Vehicle Information Charges NO ADDITIONAL DRIVERS- Veh.p: 040214 DAILY 100 FREE MILES•EXCESS AT 50,35 PER MILE Lic,p: N267719 Daily 2 44.99 day 89.98 ONLY AUTHORIZED RENTERS MAY DRIVE THE CAR. 2012 MITSUBISHI GALANT ES Excess Miles .35 /ml Fuel Out 8/8 Odom Out: 49,829 Net UM 89.98 Fuel In: 8/8 Oaom In: 49,847 Miles Driven: 18 FFRF 1 2,50 day 2.50 VEHICLE NOT ALLOWED IN MEXICO RENT 10.000 % 9.25 SALES 7,000 % 6.A8 VLF 5.500 % 5.09 Destination' 0 PCI 2 1,99 day 3.98 Subtotal of Other Charges 2730 Source: 100 28 Miles Driven: 0 Total Charges 117.28 Coverages Payment Information Payment VI 4147 5799 117.28 I have DECLINED PDW VI 414740XXXXXX5799 117,28 Total Deposits/Payments 117.28 I have DECLINED CD1•V-CORP I have DECLINED Net Due 0.00 I have DECLINED I have DECLINED Prepaid Fuel THIS ADDENDUM is Intended to provide conspicuous notice to the Authorized Renter(s)of the following: I. Paragraph 1 of the RA is amended by adding the following language: In the event the account has an unpaid balance,Customer shall pay all of Thrifty Car Rental's attorney's fees associated ' `��r with the collection of the account plus all attenciant collection cost whether litigation is Initiated or not. ' �.. II I 'ni�� " II. All authorized renter(s)agree to grant to Thrifty the right,at any time to verify their motor vehicle driving record and v authorize the appropriate governmental department to release such Information to Thrifty. I confirm that I understand that THRIFTY prohibits smoking In the rental vehicle.I agree that tam liable for a minimum charge of$250.00 if anyone smokes In the vehicle during the term of my rental III. Paragraph 3 of this RA is amended by adding the following paragraph: C. FOR PURPOSES OF THIS AGREEMENT,GROSSLY NEGLIGENT CONDUCT INCLUDES,BUT IS NOT LIMITED TO,PARKING THE CAR OR LEAVING THE CAR UNATTENDED AT A LOCATION IN THE U,S.THAT IS WITHIN 50 MILES OF THE BORDER BETWEEN THE U.S.AND MEXICO UNLESS THE CAR IS GARAGED AT A LOT THAT IS FENCED-IN,AND(ii)THE LOT HAS A PARKING ATTENDANT ON DUTY ON A 24-HOUR BASIS. , I AUTHORIZE THRIFTY TO PROCESS OR SUBMIT A CHARGE TO MY CREDIT,DEBIT OR CHARGE CARD FOR THE ESTIMATED CHARGES FOR THIS RENTAL.UPON SIGNING OF THIS RENTAL AGREEMENT,ALL ADDITIONAL CHARGES UPON RETURN OF THE VEHICLES SUCH AS A REFUELING CHARGE IF RETURNED LESS THAN THE FUEL LEVEL UPON PICKUP,OR CHARGES FOR ANY AND ALL DAMAGES, I AUTHORIZE THRIFTY TO PROCESS A CREDIT CARD VOUCHER IN MY NAME FOR CHARGES,IF ANY,FOR UNPAID TRAFFIC AND PARKING TICKETS. WE ACKNOWLEDGEAND AGREE TO THE LOCAL THRIFTY COUNTER POLICIES AND RESTRICTIONSt x X Additional Driver Signature