Organization Info

*US Only and for Customs Purposes Only*

Organization Name (required)

Organization Type

Federal Taxpayers ID (TIN or EIN)

*Please attach Sales Tax Exempt certificate if exempt*



Billing Address

Number and Street (required)

City (required)

Country (required)

State/Province (required)

Zip Code/Postal Code (required)

Telephone (required)

Fax

Accounts Payable Contact (required)

Accounts Payable Phone Number (required)

Accounts Payable Email to Send Invoices (required)

Shipping Address (No P.O. Boxes)

Number and Street (required)

City (required)

Country (required)

State/Province (required)

Zip Code/Postal Code (required)

Receiving Contact (required)

Receiving Phone Number (required)


Equipment is going to ship palletized by common carrier.

**THIS SECTION MUST BE FILLED OUT**

Do we have to take an appointment for delivery of the equipment?
YesNo

Do you have a loading dock?
YesNo

Do you have a FORK LIFT AND PALLET JACK to unload?
YesNo

Can you accommodate access for a 53' truck?
YesNo

Is the delivery address a job site?
YesNo

Is the delivery address a military base?
YesNo

If yes, is a U.S. driver required?
YesNo

Special Delivery Instructions