HTML Preview Rental Agreement Confirmation page number 1.
STATE OF CALIFORNIA
California Environmental Protection Agency
AIR RESOURCES BOARD
ED/CREB/PERS-176 (REV 09/15)
Page 1 of 2 (reverse side)
Statewide Portable Equipment Registration Program
FORM 10 - Rental Agreement Confirmation
(Auto-fill format. Press “Tab” or up/down arrows to enter information.)
PERP Registration forms are available at http://www.arb.ca.gov/portable/portable.htm.
1. PERP Registration Number:
2. Rental Company or Owner Renting or Leasing the Registered Portable Engine or
Equipment Unit
Name of Company:
Address:
City: State: Zip:
Phone Number:
Name of Contact Person:
3. Company Operating the Rented or Leased Portable Engine or Equipment Unit
Name of Company:
Address:
City:
Phone Number:
*Cell Phone Number: *FAX Number:
Name of Contact Person:
*These numbers are optional.
Keeping this form onsite with the registered engine or equipment unit meets the specific
requirement contained in Portable Equipment Registration Program Regulation section
2458(b) which states that a rental or lease agreement must be kept onsite with the
registered engine or equipment. Using this form in lieu of keeping a copy of the formal
rental agreement onsite in no way relieves the engine and/or equipment unit owner or
renter from the requirement to comply with all applicable requirements of the PERP
regulation, registration, and related conditions. Renters are advised to review the PERP
registration conditions to ensure all requirements are met during the operation of this
engine or equipment unit.