DATE          TIME ORDERED C.O.D. CHARGE PER ORDER TAKEN BY ORDER DATE EST COST NO. ROOMS YES NO YES NO INSURANCE FLIGHT/STAIRS PACKING RANGE REFRIG WASHER DRYER PIANO FREEZER EST WGT None DVP RCP SHIP FROM Select if Applicable Same As Bill To NAVL (HVP) Qwest Redman Main Record Storage (Main) Record Storage (Downtown) Redman Ogden Redman Lindon Logitrans Logitrans Air (Las Vegas) SHIP TO Select if Applicable Same As Bill To NAVL (HVP) Qwest Redman Main Record Storage (Main) Record Storage (Downtown) Redman Ogden Redman Lindon Logitrans Logitrans Air (Las Vegas) ATTN: PHONE: ATTN: PHONE: STORAGE LOT # All Out? No YES TYPE N/A Regular SIT NTS Commercial Special Records # OF PERSONNEL BILL TO Select if Applicable Same As Ship From Same As Ship To NAVL (HVP) Qwest CONTRACT # SPECIAL INSTRUCTIONS EST. PACK NEW/ USED DRUM NEW USED 1.5 NEW USED 3.0 NEW USED 4.5 NEW USED 6.0 NEW USED MIRROR NEW USED W.ROBE NEW USED TAPE NEW USED SNGL NEW USED DBL NEW USED KING QUEEN NEW USED OTHER NEW USED

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