Large car rental companies are indeed better than smaller local ones in Italy. The service is great, and the car condition is excellent. The only downside is that Italians don't work on Sundays, making the self-service return points hard to find and the return process quite troublesome. It took me over an hour to finalize it.
I liked the way the avis/budget staff at the Sorrento office worked as a team. The car at pickup wasn't filled with fuel fully as documented, but this was quickly rectified at a minimum of Inconvenience.
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