Order Form

SOLD TO
 
Your Company Name
Your Billing Address
Your Name
Your Telephone
Your E-Mail
TODAY'S DATE
YOUR PURCHASE ORDER #
WAREHOUSE PICKUP LOCATION
PRODUCT QTY PRODUCT QTY
Plastic Box/Lid - Grey Electric Stair Climber
Plastic Box/Lid - Blue 12' Solid Ramp
Plastic Box/Lid - Red 12' Split Ramp
Flat Dolly 14' Solid Ramp
Screen Dolly 14' Split Ramp
Terminal Cart 16' Split Ramp
Open Bin Hook Straps
Appliance Truck E Channel Straps
Moving Blanket Other
Safe Movers Other
SPECIAL INSTRUCTIONS
Complete only if in the Greater Toronto Area and if delivery services are required.
SHIP TO ADDRESS
(Delivery Service available only in the Greater Toronto Area)
 
Company Name
Address
Contact Name
Telephone Number
SHIP/DELIVERY DATE
(dd-mm-yyyy)
PICK-UP ADDRESS
(Delivery Service available only in the Greater Toronto Area)
 
Company Name
Address
Contact Name
Telephone Number
RETURN/PICK-UP DATE
(dd-mm-yyyy)