Customer Name Type Freight
Delivery Pick Up Schedule Date Contract
Hours Closed for Lunch
Address Correct? Correct Address
City:
Liftgate? Dock? DocK Location
T/T ACCESSIBLE (70 FT OR GREATER)? If not, Why not
Business
Residence 		Floor Room Stairs Elevator
Contact person at time of pickup/delivery
Additional Contact Numbers
Spoke with Left Message/VM
Call placed by Date Time
Notes:
Bubble J-Bars Rolla-lift Big Red Dolly Genie Stair Crawler Masonite
Pallets ZONE
Pieces
CHECK ALL EMAILS TO SEND THIS TO - MUST CHECK AT LEAST ONE BOX!!!
Annie (xerox.com) Nikki (xerox2.com) Holly (hvpdsp1.com) Montana (montanarep.com)