Quote Accept Form

Shippers details:  
E-mail address:
Tel(Home): Tel(Work):
Accepted quote.:
Do you require insurance at the rates quoted? yes no
Valued inventory: I will complete online require hard copy
Storage will be required at origin/ destination / Not Required
From:  To: 
Pick Up address:
Tel: Mobile
Packing is required on:   
Contact details after packing:
Tel: Mobile:
Date of arrival at destination:
Delivery address at destination:
Tel(Home): Tel(Work):
Email: Mobile:
Delivery access details:
Requested delivery date: 
How far can we park from the entrance of your house?  m
Are there any weight or vechile size restriction? Yes /No
If yes, please specify:
Can we use the elevator? Yes /No
Are there any obstructions to access your residence? Yes /No
Any relevant information or instruction:
If our charges are payable by company please give full details below:
Contact name:
Company name:
Company address:
I have read and accepted the terms and condition Yes / No

Additional changes can occur for: X-ray(USA),customs inspection, parking permit, etc. For complete details please see the exclusion paragraph of the contract.