Company Name

Street Address of Pickup Location

Contact Name

Suite

Contact Phone

City

Contact Fax

State

Contact Email

Zip

Does your property management company require a certificate of insurance?
 Yes No

If yes, provide the information below:
Company Name

Contact

Phone Number

What floor is the equipment on?


Is there a dock available?
 Yes No

What are the dock hours?

What are the dock height restrictions?



Is there a freight elevator?
 Yes No

Does it require scheduling?
 Yes No



Is the equipment palletized?
 Yes No

Number of pieces/pallets

Approximate Weight



Item Quantities

Please be as exact as possible to ensure all your items can be picked up.


Computers Qty PC Qty Mac
Tower/Desktop
Laptop
Server
Screens Qty Size(s)
Monitor
TV
Flat Panel
Accessories Qty
Keyboard
Mouse
Cables



Are certificates of destruction for data required?
 Yes No


Does any item weigh more than 75 pounds?
 Yes No

If yes, please describe:




Any special requirements or instructions?