NOTE: After filling out the form, and clicking send, please scroll to the bottom of the page for possible error messages.

    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