Preview
FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019
NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022
EXHIBIT B
FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019
NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF KINGS
_____.._______________________.......... . X
DARIO ROSARIO,
Plaintiff, Index No.: 516285/2019
-against- AFFIDAVIT OF
SEAN DERENCIN
SUNBELT RENTALS, INC., PEREZ JAVIER,
BROOKLYN GC LLC and QUALITY FACILITY
SOLUTIONS CORP.,
Defendants.
------ X
SUNBELT RENTALS, INC.,
Third-Party Plaintiff,
-against-
BROOKLYN GC LLC,
Third-Party Defendant.
__.·--- X
BROOKLYN GC LLC,
Second Third-Party Plaintiff,
-against-
QUALITY FACILITY SOLUTIONS CORP.,
Second Third-Party Defendant.
-------------- -- X
STATE OF NEW YORK )
) ss.:
COUNTY OF SUFFOLK )
SEAN DERENCIN, being duly sworn, attests to the following:
1. I am employed as a Driver for defendant/third-party plaintiff Sunbelt Rentals, Inc.
("Sunbelt"), an equipment rental company.
FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019
NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022
2. In support of Sunbelt's motion to dismiss and summary judgment, I submitted an
Affidavit dated February 17, 2021 with an Exhibit 1. A true and correct copy of my Affidavit
with Exhibit filed with the Court ("Affidavit") on September 20, 2021 is annexed hereto as
"A."
Exhibit
3. Based on my training and in the regular course of my dutics, I am familiar with
the process for which Sunbelt n,aintains itsdocuments and/or business records. I am qualified to
make thisAffidavit and have authority on behalf of Sunbelt to do so.
4. Exhibit 1 attached to my Affidavit is a genuine and authentic copy of the delivery
ticket ("Delivery Ticket") for the subject forklift to 123 Melrose Street, Brooklyn, New York
1 1206.
5. The Delivery Ticket attached to my Affidavit as Exhibit 1 isannexed hereto and
was made by the personnel or staff of Sunbelt, or persons acting under itscontrol, in the regular
course of business, at the time of the act, transaction, occurrence or event recorded therein, or
within a reasonable time thereafter, and that itwas the regular course of business to make such
records.
SE D · RENCIN
ACKNOWLEDGEMENT
STATE OF NEW YORK, OUNTY OF SUFFOLK
On the/)4Cday _, , 2021, before me, the undersigned, a Notary Public in and for
the said State, appeared Scan Defenciü, personally known to me or proved to me on the basis
personally
of evidence to be the individual whose name issubscribed to the foregoing Affidavit and
satisfactory
acknowledged to me that he executed the same in his capacity, and that by his signature on the
instrument, the person upon behalf of which the individual acted, executed the instrumen .
FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019
NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022
EXHIBIT A
FILED::
(FILED KINGS
KINGS COUNTY
COUNTY CLERK
CLERK 03/02/2022
09/20 /2021 03:34
02 :33 PM
PNG
INDEX
INDEX NO.
NO. 516285/2019
516285/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 144
106 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 03/02/2022
09/20/2021
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF KINGS
.......___............
.. ..........
...
.... . .. -X
DARIO ROSARIO,
Plaintiff, Index No.: 516285/2019
-against- AFFIDAVIT OF
SEAN DERENCIN
SUNBELT RENTALS, INC., PEREZ JAVIER,
BROOKLYN GC LLC and QUALITY FACILITY
SOLUTIONS CORP.,
Defendants.
X
SUNBELT RENTALS, INC.,
Third-Party Plaintiff,
-against-
BROOKLYN GC LLC,
Third-Party Defendant.
.. ...
.... .. .. ....
---X
BROOKLYN GC LLC,
Second Third-Party Plaintiff
-against-
QUALITY FACILITY SOLUTIONS CORP.,
Second Third-Party Defendant.
._ ----- -----------X
STATE OF NEW YORK )
) ss.:
COUNTY OF SUFFOLK )
SEAN DERENCIN, being duly sworn, attests to the following:
1. I am employed as a Driver for defendant/third-party plaintiff Sunbelt Rentals Inc.
("Sunbelt"), an equipment rental company.
FILED:
FILED : KINGS
KINGS COUNTY
COUNTY CLERK
CLERK 03/02/2022
09/ 20 /2021 03:34
02 :33 PM
P14
INDEX
INDEX NO.
NO. 516285/2019
516285/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 144
106 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 03/02/2022
09/20/2021
2. On April 10, 2019, I delivered a Toyota Model: 8FGU25 forklift with serial
#82329 and asset #: 1037436 ("the subject forklift") to a construction site located at 123 Melrose
Street, Brooklyn, New York 11206 ("jobsite") based on the rental agreement between Sunbelt
and itscustomer, Brooklyn GC LLC ("Brooklyn GC").
3. I was picking up another Toyota Model: 8FGU25 forklift with serial #82223 and
asset #: 1038434 and replacing that forklift with the subject forklift as Brooklyn GC had advised
"1"
that there was an issue with asset #: 1038434. Annexed hereto as Exhibit is a true and
correct copy of the delivery ticket for the subject forklift to the jobsite.
4. Sunbelt did not perform any work, labor, services or construction at the jobsite.
5. Sunbelt did not operate the subject forklift while itwas on the jobsite.
6. Once Sunbelt drops off rented equipment to a customer i no control of where
a customer uses or places the equipment.
// SEAN ÒERENCIN
ACKNOWLEDGEMEN__T
STATE OF NEW YO ÓO TY OF SUFFOLK
On the a 2021, before me, the undersigned,.a Notary Public in and for
the said State,personally appeared 5 an Derencin, personally known to me or proved to me on the basis
of satisfactory evidence to be the individual whose name is subscribed to the foregoing Affidavit and
acknowledged to me that he executed the same in his capacity, and that by his signature on the
instrument, the person upon behalf of which the indiv'dtfatacted,executedthe instrurpe
Nota biic
N ry 'uhlic.Sble of New Yo
Reyhtrallon //0IBl6033614
2 (I In Suffdk
County
FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019
NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022
FILED::
IFILED KINGS
KINGS COUNTY
COUNTY CLERK
CLERK 03/02/2022 03:34 33 PM INDEX
INDEX NO.
NO. 516285/2019
516285/2019
NYSCEF
NYSC DOC.
C. NO.
NO. 144
106 RECEIVED
CEIVED NYSCEF:
NYSCEPgg)9 03/02/2022
20/2021
NBf X •
REN TA ,
PC#: 0668
150 NASSAU 321978
ISLIP,NY 11
631-224 500
EXCHANGE PICK
NE CONSTRUCTION
123 MELROSE STREET
BROOKLYN, NY 11206 6110
Contract #.. 79480120
Contract dt. 4109/19
C#: 718.887 9840 J#: 7f 8-887-9840
Date out....6/08/18 8:00 AM
Pickup date. 4/09/19 2:24 PM
Customer: 626092
Job Loc.....
123 MELROSE STREET, BROOKLY
BR00KLYN GC LLC - NEW
Job 4
No...... CONSTRUCTION
12 SPENCER STREET #3
P.0. #......
123M
BROOKLYN, NY 11205
Ordered By.. RON, RON
NET DUE UPON RECElPT
Equipment # Fuel Used Oty Ret Qty Damaged
Qty
***** Pick *****
Up
1.00 5000LB IND FORKLIFT DF
1038434 Make: TOYOTA Model: 8FGU25 Ser #: 82223 D
CIRCLE FUEL TANK STATUS: F 3/4 1/2 /4 E CUSTOMsR INITIALS:
1 00 I FORKLIFT DF
1037436 Make: TOYOTA Model: 8FGU25 Ser #: 8FGU25-82329
*** DELIVERY INSTRUCTIONS ***
Moshe 914 299 7590
Customer Damage to machine
Sean
Dropped on evergreen and Mel rose st
Steve c
Mast is stuck in the up position the
customer can I drive machine out
MULTIPLESHIFTS OR CUSTOMERIS RESPONSIBLEFOR
OVERTIMERATES MAY APPLY REFUELE DAMAGES AND REPA1RS
CUSTOMERSIGNATURE DATE AME PRINTED DEL1VEREDBY DATE
FILED:
FILED: KINGS
KINGS COUNTY
COUNTY CLERK
CLERK 03/02/2022
O9/20/2021 03:34
02:33 PM
PNG
INDEX
INDEX NO.
NO. 516285/2019
516285/2019
NYSCEF
NYS DOC.
C. NO.
NO. 144
106 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 03/02/2022
Op / 0
2
SUNBER.T.
R E N TA L S
SUNBELT RENTALS, INC.
PC#f 0668
150 NASSAU AVENUE Q66%d1 GEARY
Salesman; BUSH, (n68)
ISUP NY 11751
Typed By: KOCONNOR
631-224-5000
Job Site: RENTAL OUT
NEW CONSTRUCTION
123 MELROSE STREET
BROOKLYN, NY 11206 6110
Contract #.. 79480120
C#: 7182887-9840 J#; 718-887-9840 Contract dt. 6/O7/18
Date out.... 6/O8/18 8:00 AM
Eat teturn.. 7/06/18 8:00 AM
Customer: 626092
Job Loc..s.. 123 MELROSE STREET, BROOKLYN
BROOKLYN GC LLC -
Job No...... 4 NEW CONSTRUCTION
11 SPENCER STREET #3
P.0 # "" 123M
BROOKLYN, NV 11205
Ordered By.. Blum , Moshe
NET DUE UPONRECElPT
QTY EQUIPMENT # Min Day Week 4 Week Amount
1.00 5000LB 1ND FORKLIFT DF REDACTED REDACTED REDACTED REDACTED N/C
1037436 Make: TOYOTA Model: 8FGU25 Ser #t 8FGU25-82329
IND FORKLIFT 5009LB,TOYOTA,BFGU.25,DF,NMT,SID.E,ALRM
HR OUT: 361.000
*** EQP MSG ***
** ALWAYS REFER TO THE EQUIPMENT T.aOAD CHAftT AS TO ACTUAL LIFTING
CAPACITIES IN ALL THE EQUIPMENTES LOAD RANGES **
WARNING - FORKLIFTS ARE NOT TO BE USED FOR LIFT1NG PERSONNEL
SALES ITEMS:
Qty IteIn number Unit Price
1 ENVIRONMENTAL EA
ENVIRONMENTAL
RENTAL PROTECTION PLAN
DELIVERY INSTRUCTIONS:
Moshe 914 299 7590
Customer Damage to machine
Sean
Dropped on evergreen and Mel rose st
Steve c
...e.o....................................................................... ., ...............m..........e.....
. Rate your em:fea
rental www.sunbs:¾#‡± corá/surirov .
L Thetotalcharges
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provided
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essemes
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withtheEquipment
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during Period, lajwyanddamage
including topersons, andthmEquipment
property
3. Customer
isresponsible
forandshallenty
permit Anthesized
trained.
property Individuals
tousetheEquipment.
4. If theEquipment
does
notoperate isnotsuitable
properly, IsrCustomer's
intendeddoes
use, noth±e± hasanyquestions
eper::!qed safetyinstructions
orCustomer usenitheEquipment,
regarding Customer
shallantnee1At and
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shallcontact
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Eatitlesfatall.claigns-ss
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ermalfunctioning
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hasreceived, + _=md totheestirp=*=॥
agrees enthispage,
andalltheIerms plussilsections
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Release
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explanation atwww.sunbeltrard±!•
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isavailable ce=1±•_•rcharge.
L mustcontact
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torequest of Equipment,
pickup retainthePich·Up
Number andwillbarssponsible1or
givenbySunbelt Eiluipment retrieved
untilactuallyhySunbelt.
B. Customer itsrighttoajurytrialin anydispute
waives assatforthinSection
19.
9, Attheelection orCastomer,
ofSunbell Customer lesubmit
agrees everydisp:::!‡W!r:!ice andwaives
anyrighttobringaclassaction
assetferthinSection
20.
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1E ninnah
numming riggectign sigeigrgetshis;
run iseutaWnite Ms merAmiguisp
ontinued on the next page...
* * www _suribeltreritals.com
* RNTQUTP2P
IRev03{23118
FILED:
IFILED: KINGS
KINGS COUNTY
COUNTY CLERK
CLERK 03/02/2022
09/20/2021 03:34
02:33 PM
PNG
INDEX
INDEX NO.
NO. 516285/2019
516285/2019
NYSCEF
NYS DOC.
C. NO.
NO. 144
106 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 03/02/2022
/220#2
SUN :
ELT.
R ENTA L 5
SUNBELT RENTALS, INC.
PC#: 0668
150 NASSAU AVENUE Salesman: 066801 GEARY
BUSH, (668)
ISLIP ' NY 11751
Typed By: KOCONNOR
631-224-5000
Job Site: RENTAL OUT
NEW CONSTRUCTION
123 MELROSE STREET
BROOKLYN, NY 11206 6110
Contract #.. 79480120
C#: 718-887-9840 J#: 718-887-9840 Contract dt. 6/O7/18
Date out.... 6/08/18 8:00 AM
Est return.. 7/06/18 8:00 AM
Customer 626092
Job Loc..... 123 MELROSE STREET, BROOKLYN
BROOKLYN GC LLC -
Job No...... 4 NEW CONSTRUCTION
12 SPENCER STREET #3
P.O. # """ 123M
BROOKLYN, NY 11205
Ordered By.. Blum , Moshe
NET DUE UPON RECEIPT
QTY EQUIPMENT # Min Day Week 4 Week Amount
Mast is stuck in the up position the
customer can I drive machine out
Sean
Dropped by ramp between the 2 new
buildings on Stanwix st
All amounts are in USD
.e....e.e....e,.................................................................................................
. Rate vour rentalexperiencewww.st--t cc:-:!swvey .
1. The=:" ±:7 areanestimana
based
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andetherinformation
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does
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intended andsafetyinstructions
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Customer and
shallcontact
Sunbell
immediately.
5. Equipment
misuse damaged
atusing er-r.;|:;.r.;th-IriiEquipment
mayresultinserious
bodilyinjuryerdeath
andCustomer
agrees
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ormalfunctioning
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|Customer
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Customer
Signators Date Name
Printed Delivered
By Date
* * www.sunbeltrentals.corn
** RNTOUTP2P
(Rev03t23r18|
Preview
FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019 NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022 EXHIBIT B FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019 NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF KINGS _____.._______________________.......... . X DARIO ROSARIO, Plaintiff, Index No.: 516285/2019 -against- AFFIDAVIT OF SEAN DERENCIN SUNBELT RENTALS, INC., PEREZ JAVIER, BROOKLYN GC LLC and QUALITY FACILITY SOLUTIONS CORP., Defendants. ------ X SUNBELT RENTALS, INC., Third-Party Plaintiff, -against- BROOKLYN GC LLC, Third-Party Defendant. __.·--- X BROOKLYN GC LLC, Second Third-Party Plaintiff, -against- QUALITY FACILITY SOLUTIONS CORP., Second Third-Party Defendant. -------------- -- X STATE OF NEW YORK ) ) ss.: COUNTY OF SUFFOLK ) SEAN DERENCIN, being duly sworn, attests to the following: 1. I am employed as a Driver for defendant/third-party plaintiff Sunbelt Rentals, Inc. ("Sunbelt"), an equipment rental company. FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019 NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022 2. In support of Sunbelt's motion to dismiss and summary judgment, I submitted an Affidavit dated February 17, 2021 with an Exhibit 1. A true and correct copy of my Affidavit with Exhibit filed with the Court ("Affidavit") on September 20, 2021 is annexed hereto as "A." Exhibit 3. Based on my training and in the regular course of my dutics, I am familiar with the process for which Sunbelt n,aintains itsdocuments and/or business records. I am qualified to make thisAffidavit and have authority on behalf of Sunbelt to do so. 4. Exhibit 1 attached to my Affidavit is a genuine and authentic copy of the delivery ticket ("Delivery Ticket") for the subject forklift to 123 Melrose Street, Brooklyn, New York 1 1206. 5. The Delivery Ticket attached to my Affidavit as Exhibit 1 isannexed hereto and was made by the personnel or staff of Sunbelt, or persons acting under itscontrol, in the regular course of business, at the time of the act, transaction, occurrence or event recorded therein, or within a reasonable time thereafter, and that itwas the regular course of business to make such records. SE D · RENCIN ACKNOWLEDGEMENT STATE OF NEW YORK, OUNTY OF SUFFOLK On the/)4Cday _, , 2021, before me, the undersigned, a Notary Public in and for the said State, appeared Scan Defenciü, personally known to me or proved to me on the basis personally of evidence to be the individual whose name issubscribed to the foregoing Affidavit and satisfactory acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the person upon behalf of which the individual acted, executed the instrumen . FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019 NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022 EXHIBIT A FILED:: (FILED KINGS KINGS COUNTY COUNTY CLERK CLERK 03/02/2022 09/20 /2021 03:34 02 :33 PM PNG INDEX INDEX NO. NO. 516285/2019 516285/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 144 106 RECEIVED RECEIVED NYSCEF: NYSCEF: 03/02/2022 09/20/2021 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF KINGS .......___............ .. .......... ... .... . .. -X DARIO ROSARIO, Plaintiff, Index No.: 516285/2019 -against- AFFIDAVIT OF SEAN DERENCIN SUNBELT RENTALS, INC., PEREZ JAVIER, BROOKLYN GC LLC and QUALITY FACILITY SOLUTIONS CORP., Defendants. X SUNBELT RENTALS, INC., Third-Party Plaintiff, -against- BROOKLYN GC LLC, Third-Party Defendant. .. ... .... .. .. .... ---X BROOKLYN GC LLC, Second Third-Party Plaintiff -against- QUALITY FACILITY SOLUTIONS CORP., Second Third-Party Defendant. ._ ----- -----------X STATE OF NEW YORK ) ) ss.: COUNTY OF SUFFOLK ) SEAN DERENCIN, being duly sworn, attests to the following: 1. I am employed as a Driver for defendant/third-party plaintiff Sunbelt Rentals Inc. ("Sunbelt"), an equipment rental company. FILED: FILED : KINGS KINGS COUNTY COUNTY CLERK CLERK 03/02/2022 09/ 20 /2021 03:34 02 :33 PM P14 INDEX INDEX NO. NO. 516285/2019 516285/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 144 106 RECEIVED RECEIVED NYSCEF: NYSCEF: 03/02/2022 09/20/2021 2. On April 10, 2019, I delivered a Toyota Model: 8FGU25 forklift with serial #82329 and asset #: 1037436 ("the subject forklift") to a construction site located at 123 Melrose Street, Brooklyn, New York 11206 ("jobsite") based on the rental agreement between Sunbelt and itscustomer, Brooklyn GC LLC ("Brooklyn GC"). 3. I was picking up another Toyota Model: 8FGU25 forklift with serial #82223 and asset #: 1038434 and replacing that forklift with the subject forklift as Brooklyn GC had advised "1" that there was an issue with asset #: 1038434. Annexed hereto as Exhibit is a true and correct copy of the delivery ticket for the subject forklift to the jobsite. 4. Sunbelt did not perform any work, labor, services or construction at the jobsite. 5. Sunbelt did not operate the subject forklift while itwas on the jobsite. 6. Once Sunbelt drops off rented equipment to a customer i no control of where a customer uses or places the equipment. // SEAN ÒERENCIN ACKNOWLEDGEMEN__T STATE OF NEW YO ÓO TY OF SUFFOLK On the a 2021, before me, the undersigned,.a Notary Public in and for the said State,personally appeared 5 an Derencin, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the foregoing Affidavit and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the person upon behalf of which the indiv'dtfatacted,executedthe instrurpe Nota biic N ry 'uhlic.Sble of New Yo Reyhtrallon //0IBl6033614 2 (I In Suffdk County FILED: KINGS COUNTY CLERK 03/02/2022 03:34 PM INDEX NO. 516285/2019 NYSCEF DOC. NO. 144 RECEIVED NYSCEF: 03/02/2022 FILED:: IFILED KINGS KINGS COUNTY COUNTY CLERK CLERK 03/02/2022 03:34 33 PM INDEX INDEX NO. NO. 516285/2019 516285/2019 NYSCEF NYSC DOC. C. NO. NO. 144 106 RECEIVED CEIVED NYSCEF: NYSCEPgg)9 03/02/2022 20/2021 NBf X • REN TA , PC#: 0668 150 NASSAU 321978 ISLIP,NY 11 631-224 500 EXCHANGE PICK NE CONSTRUCTION 123 MELROSE STREET BROOKLYN, NY 11206 6110 Contract #.. 79480120 Contract dt. 4109/19 C#: 718.887 9840 J#: 7f 8-887-9840 Date out....6/08/18 8:00 AM Pickup date. 4/09/19 2:24 PM Customer: 626092 Job Loc..... 123 MELROSE STREET, BROOKLY BR00KLYN GC LLC - NEW Job 4 No...... CONSTRUCTION 12 SPENCER STREET #3 P.0. #...... 123M BROOKLYN, NY 11205 Ordered By.. RON, RON NET DUE UPON RECElPT Equipment # Fuel Used Oty Ret Qty Damaged Qty ***** Pick ***** Up 1.00 5000LB IND FORKLIFT DF 1038434 Make: TOYOTA Model: 8FGU25 Ser #: 82223 D CIRCLE FUEL TANK STATUS: F 3/4 1/2 /4 E CUSTOMsR INITIALS: 1 00 I FORKLIFT DF 1037436 Make: TOYOTA Model: 8FGU25 Ser #: 8FGU25-82329 *** DELIVERY INSTRUCTIONS *** Moshe 914 299 7590 Customer Damage to machine Sean Dropped on evergreen and Mel rose st Steve c Mast is stuck in the up position the customer can I drive machine out MULTIPLESHIFTS OR CUSTOMERIS RESPONSIBLEFOR OVERTIMERATES MAY APPLY REFUELE DAMAGES AND REPA1RS CUSTOMERSIGNATURE DATE AME PRINTED DEL1VEREDBY DATE FILED: FILED: KINGS KINGS COUNTY COUNTY CLERK CLERK 03/02/2022 O9/20/2021 03:34 02:33 PM PNG INDEX INDEX NO. NO. 516285/2019 516285/2019 NYSCEF NYS DOC. C. NO. NO. 144 106 RECEIVED RECEIVED NYSCEF: NYSCEF: 03/02/2022 Op / 0 2 SUNBER.T. R E N TA L S SUNBELT RENTALS, INC. PC#f 0668 150 NASSAU AVENUE Q66%d1 GEARY Salesman; BUSH, (n68) ISUP NY 11751 Typed By: KOCONNOR 631-224-5000 Job Site: RENTAL OUT NEW CONSTRUCTION 123 MELROSE STREET BROOKLYN, NY 11206 6110 Contract #.. 79480120 C#: 7182887-9840 J#; 718-887-9840 Contract dt. 6/O7/18 Date out.... 6/O8/18 8:00 AM Eat teturn.. 7/06/18 8:00 AM Customer: 626092 Job Loc..s.. 123 MELROSE STREET, BROOKLYN BROOKLYN GC LLC - Job No...... 4 NEW CONSTRUCTION 11 SPENCER STREET #3 P.0 # "" 123M BROOKLYN, NV 11205 Ordered By.. Blum , Moshe NET DUE UPONRECElPT QTY EQUIPMENT # Min Day Week 4 Week Amount 1.00 5000LB 1ND FORKLIFT DF REDACTED REDACTED REDACTED REDACTED N/C 1037436 Make: TOYOTA Model: 8FGU25 Ser #t 8FGU25-82329 IND FORKLIFT 5009LB,TOYOTA,BFGU.25,DF,NMT,SID.E,ALRM HR OUT: 361.000 *** EQP MSG *** ** ALWAYS REFER TO THE EQUIPMENT T.aOAD CHAftT AS TO ACTUAL LIFTING CAPACITIES IN ALL THE EQUIPMENTES LOAD RANGES ** WARNING - FORKLIFTS ARE NOT TO BE USED FOR LIFT1NG PERSONNEL SALES ITEMS: Qty IteIn number Unit Price 1 ENVIRONMENTAL EA ENVIRONMENTAL RENTAL PROTECTION PLAN DELIVERY INSTRUCTIONS: Moshe 914 299 7590 Customer Damage to machine Sean Dropped on evergreen and Mel rose st Steve c ...e.o....................................................................... ., ...............m..........e..... . Rate your em:fea rental www.sunbs:¾#‡± corá/surirov . L Thetotalcharges ataunastimag ebased rentalperiod ontheaslimated andatherinfemallon provided byCustomer, 1!osiomer essemes allrisksussociated withtheEquipment theRental during Period, lajwyanddamage including topersons, andthmEquipment property 3. Customer isresponsible forandshallenty permit Anthesized trained. property Individuals tousetheEquipment. 4. If theEquipment does notoperate isnotsuitable properly, IsrCustomer's intendeddoes use, noth±e± hasanyquestions eper::!qed safetyinstructions orCustomer usenitheEquipment, regarding Customer shallantnee1At and EquipuMnt shallcontact Sunbelt immedia tely. 5 misuse Equipment orusing damaged ormalfunct½ri-; mayresultin...;...'..J;, E---i;"rent andCustomer ;.,;.4 erdeath thatCust agrees allrishassociated omerli)assumes and(ii)indemntlies thereunder, Sunbelt Eatitlesfatall.claigns-ss asaresultofmisuse damages oruseofdamaged ermalfunctioning Equipment. 6, Customer readaMa hasreceived, + _=md totheestirp=*=‡•• agrees enthispage, andalltheIerms plussilsections enthereverse sideofthisCentract ("Sections"L andIndemnification Release including inSection 8andEnvironmenta IeeinSection !=:'m:p,- explanation atwww.sunbeltrard±!• 16.whichcanalsobeloundat--..6%.-.a.:....mtrentalcontract. 'DeliveryJPichup isavailable ce=1±•_•rcharge. L mustcontact Customer Sunbelt torequest of Equipment, pickup retainthePich·Up Number andwillbarssponsible1or givenbySunbelt Eiluipment retrieved untilactuallyhySunbelt. B. Customer itsrighttoajurytrialin anydispute waives assatforthinSection 19. 9, Attheelection orCastomer, ofSunbell Customer lesubmit agrees everydisp:::!‡W!r:!ice andwaives anyrighttobringaclassaction assetferthinSection 20. Usgemei 1E ninnah numming riggectign sigeigrgetshis; run iseutaWnite Ms merAmiguisp ontinued on the next page... * * www _suribeltreritals.com * RNTQUTP2P IRev03{23118 FILED: IFILED: KINGS KINGS COUNTY COUNTY CLERK CLERK 03/02/2022 09/20/2021 03:34 02:33 PM PNG INDEX INDEX NO. NO. 516285/2019 516285/2019 NYSCEF NYS DOC. C. NO. NO. 144 106 RECEIVED RECEIVED NYSCEF: NYSCEF: 03/02/2022 /220#2 SUN : ELT. R ENTA L 5 SUNBELT RENTALS, INC. PC#: 0668 150 NASSAU AVENUE Salesman: 066801 GEARY BUSH, (668) ISLIP ' NY 11751 Typed By: KOCONNOR 631-224-5000 Job Site: RENTAL OUT NEW CONSTRUCTION 123 MELROSE STREET BROOKLYN, NY 11206 6110 Contract #.. 79480120 C#: 718-887-9840 J#: 718-887-9840 Contract dt. 6/O7/18 Date out.... 6/08/18 8:00 AM Est return.. 7/06/18 8:00 AM Customer 626092 Job Loc..... 123 MELROSE STREET, BROOKLYN BROOKLYN GC LLC - Job No...... 4 NEW CONSTRUCTION 12 SPENCER STREET #3 P.O. # """ 123M BROOKLYN, NY 11205 Ordered By.. Blum , Moshe NET DUE UPON RECEIPT QTY EQUIPMENT # Min Day Week 4 Week Amount Mast is stuck in the up position the customer can I drive machine out Sean Dropped by ramp between the 2 new buildings on Stanwix st All amounts are in USD .e....e.e....e,................................................................................................. . Rate vour rentalexperiencewww.st--t cc:-:!swvey . 1. The=:" ±:7 areanestimana based ontheestimated rentalperiod andetherinformation provided byCustomer. 2. Customer assumer ±!MW ==±± withtheEquipment theRental during Period, injuryanddamaga including topersons, andtheEquipment. property 3. Customer isresponsible Israndshallenlypermitproperly trsined. Autherued tousetheEquipment. Individuals 4. 11theEquipmer11 does not.g...I. pi.g.dy,isnotsuitable forCustomer's use.doesnothaveoperating intended andsafetyinstructions atCustomer hms. =e+g useaftheEqeipment.shaltnutusethe£quipment Customer and shallcontact Sunbell immediately. 5. Equipment misuse damaged atusing er-r.;|:;.r.;th-IriiEquipment mayresultinserious bodilyinjuryerdeath andCustomer agrees thatCustomer al1ristassacIated (ilassumes and601ndemmifies therenader, Sumbeft Eatitissfer allslaimser d=7• ±eet±eultofmisuse stuseofdamaged Equipment. ormalfunctioning B. Cusgemer hasreceived,read,-ê±± ±Magrees r- totheestitr•' ±Malliketermsonthispage, plusallsections ofthisCentract enthereverse side Relemme ("Settions"1.iestuding andIndemnification insettlen8andEnvironmenta IB.whichcanalsebefound FeeinSeclion atwww.- °Uelives -4±m enièieä‡ié¿L lee=;±:±: Surcharge y/Plckup !: available m1 www.sunbeltrostals.comlsurnharge. 7. Customer mustcontact Sunbult lerequest atEquipment. pickup retainthePickIIpNumber given bySunbelt andwi:|te.eip.-GJ. terEquipment until±=!!y -P::d bySuntalL 8. Costamer waives igsrighttoajurytrialinanydispute assetforthinSection 19. 9. ofSunbelt Attheelection Customer orCostemer, agrees tosubmit toarbitration everydispute andwaives 20. anyrightto bringaclassactiusassetfarthin5eclien Custemur IIentalProtectics isdeclining Plan[seaInverse sidefordegails| |Customer Initials) Customer Signators Date Name Printed Delivered By Date * * www.sunbeltrentals.corn ** RNTOUTP2P (Rev03t23r18|