Company Name
Street Address of Pickup Location
Contact Name
Suite
Contact Phone
City
Contact Fax
State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Contact Email
Zip
Does your property management company require a certificate of insurance? YesNo
If yes, provide the information below: Company Name Contact Phone Number
What floor is the equipment on?
Is there a dock available? YesNo
What are the dock hours?
What are the dock height restrictions?
Is there a freight elevator? YesNo
Does it require scheduling? YesNo
Is the equipment palletized? YesNo
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
Keyboard
Mouse
Cables
Are certificates of destruction for data required? YesNo
Does any item weigh more than 75 pounds? YesNo
If yes, please describe:
Any special requirements or instructions?
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