Page 56 - Gulf Coast Division - Training Manual 5 -18

Trailer Agreement Inspection Form

A Mandatory visual inspection of the loaned equipment is required involving the Ben E. Keith Driver who delivers
the equipment and a responsible representative of the Customer who is ultimately responsible for the well being
and care of the Ben E. Keith equipment.

This visual inspection will occur at the time the equipment is delivered and again at the time of picking up the
equipment. The Customer representative who is involved in the inspection upon delivery will also be the same
upon the inspection at the time of pick up.

Any and all damage of the Ben E. Keith equipment occurring at the physical site is the Customer’s responsibility
and will be assumed by and paid for by the Customer and/or the Customers Insurance Carrier.

Please note any physical damage which may be present on the trailer at the time of delivery. Failure to do so may
result in the Customer being held responsible for damages notated at the time of pick up at the end of the
agreement period.

Please use the following Key on trailer diagrams below:

• Dents/ dings – Use an X
• Scratches/ Scuffs – Use a dash ---
• Other mark with a circle – O

______ Ramps included with trailer ______ Steps hung on side door

______ Bulk heads included with trailer ______ Other items – list below

Note any additional comments below:

Condition of the parking lot___________________ Level _______________
Diesel Fuel Gage level at delivery: Full ¾ Full ½ Full ¼ Full

Unit Running? Yes ____ No ____
At Delivery: Freezer Compartment Set Point temperature ____ Cooler Compartment Set Point Temperature ____

Customer Name _________________________________________ Date _____________________

Customer Responsible Associate - Print Name ___________________________________________
Customer Responsible Associate - Signature ___________________________________________

Ben E. Keith Route Service Associate - Print Name ________________________________________

Ben E. Keith Route Service Associate – Signature _________________________________________

November 2014 Page 1