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8 2 <br /> Checked out Items, Continued <br /> Item Quantity checked Quantity checked Comments <br /> out in <br /> Table stainless steel 1 <br /> Table eviscerating 1 <br /> Trash barrel 1 <br /> Kitchen Trash Cans 2 <br /> Supply crate 1 <br /> Transformer (110-220v) 1 <br /> NSF Water Hose (75 ft) 1 <br /> Employee Initials <br /> I, the User, for myself, my heirs, executors, and assigns, do hereby voluntarily and with full knowledge <br /> of the consequences of my actions: release and waive any legal rights I have or may have to seek <br /> payment or relief of any kind from the persons and entities named in this paragraph. Furthermore, I <br /> shall indemnify, defend and save harmless Durham County, Orange County, NC State University, the <br /> State of North Carolina, and their respective trustees, officers, agents, and employees (the "indemnified <br /> persons and entities") from all liabilities, losses, costs, damages, claims or causes of action of any kind <br /> or nature whatsoever, and expenses, including attorneys' fees, arising or claimed to have arisen out of <br /> personal injuries or death, or property damage or loss, sustained by the User as a result of User's <br /> operation of the MPU, as well as those injuries or property damage sustained by others as a result of <br /> the User's operation of the MPU. I understand that I am fully responsible for my own safety, my own <br /> insurance coverage, and any other risk management measures applicable to my use of the MPU. <br /> User Name (print) Signature Date <br /> Address: Phone Number: <br /> Rental Period <br /> Date/Time From: Date/Time To: <br /> Actual Pickup Date/Time Actual Drop-off Date/Time <br /> Representative <br /> Signature Printed Name Date <br /> Approved DCo 09.19.2022 <br />