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Quote / Order Form
Please Fill in all Necessary Information

Quote: Order:

Do you have an Account Yes: No: If Yes please Fill your Account#

Contact Information:
Name: Phone: E-Mail:

Do you want us to call back to confirm?
Yes: No:

Pick up Information:
P/U Name:

Ready By:

Month: Day: Time: am: pm:

P/U Address:
Phone: Ext:

Delivery Information:
Del. Name: 

Del. By: Month: Day: Time: am pm:

Del. Address:
Phone: Ext:

Service Information:
Number of Pieces:  Weight: Size: 

Type: Env:  Box:    Other: 

Bill or Quote to:
Pickup location     delivery location account# Other

Name:

Address: 
Phone: E-Mail:

Special Instructions: