At Your Service Transportation
, Inc.
Delivery Services Quote Request
For any product or special items.
Items with * must be filled out.
Are you currently working with a Bekins agent? If so who:
Date:
*
Company Name:
*
Your Name:
*
Telephone:
*
E-mail:
*
Repeat Your E-mail:
*
Origin (City)
(State)
*
(5 digit Zip)
*
*
Destination (City)
(State)
*
(5 digit Zip)
*
*
Product Shipping:
*
Number of Pieces:
*
Total Weight:
*
Size of pieces:
Please use inches.
Pc.1 (L x W x H):
x
x
*
Weight:
*
Pc.2 (L x W x H):
x
x
Weight:
Pc.3 (L x W x H):
x
x
Weight:
Pc.4 (L x W x H):
x
x
Weight:
Pc.5 (L x W x H):
x
x
Weight:
Pc.6 (L x W x H):
x
x
Weight:
Additional Insurance Requested for the Declared Value of $
Residential Pick Up:
Yes
Residential Delivery:
Yes
Service Required
on Delivery:
Inside Placement
Yes
How many stairs
Requires Assembly
Yes
Special Instructions:
[
White Glove Home Delivery
] [
Other Delivery Services
]
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Last Update 03/06/09