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Courier / Delivery Service
When Needed?
Pickup/Delivery Information

Pickup or Service Location
 
Pickup or Service Company Name
 
Pickup or Service Location Contact Name
 
Drop-Off Location
 
Delivery Destination Company Name
Delivery Destination Contact Name
 
Delivery Destination Contact Phone
 
Delivery Destination Contact Email
 
Delivery/Arrival Time
Number of Packages To Same Destination
 
Weigt of Each Item (in LBS - Round up to Nearest Pound, Numbers Only, put weight of heaviest item)
 
Dimensions of Item in Inches (Example 16H X 32W X 15D)
Request Description
 
Distance
Est. Ride or Delivery Charge