Inside Delivery Information Worksheet (page 1 of 2)

Date:	________________________	No. of Pages:	________________________
To:	________________________	To:	________________________
Co:	________________________	Co:	________________________
Phone:	________________________	Phone:	________________________
Fax	________________________	Fax	________________________
Please complete this worksheet as fully as possible. If information is not correct or thorough, it could result in additional charges to make delivery. This quote is valid for (30) days. If information is not accurate, this price quote will be null and void.

Ship to Address:
_____________________________	Main Contact:	________________________
_____________________________	(Phone for this contact):	________________________
_____________________________	(Fax for this contact):	________________________
_____________________________	Second Contact:	________________________
_____________________________	(Phone for this contact):	________________________
Union Delivery? (circle one)   Yes   No	(Fax for this contact):	________________________

Product Information:
Quantity	Model Number	Dimensions	Weight/unit
_______	_____________________	_____________________	_______
_______	_____________________	_____________________	_______
_______	_____________________	_____________________	_______
_______	_____________________	_____________________	_______
_______	_____________________	_____________________	_______
		Total Weight:	_______

Door Dimensions:
Entry door to building:	(Width) __________	(Height) __________
Door Dimensions to room where the unit is to be placed:
	(Width) __________	(Height) __________
Any other door dimensions that will be involved in the delivery of unit:
	(Width) __________	(Height) __________
Elevator Availability:	(Yes) ___________	(No) _____________
Dimensions of Elevator: _______________________________________________
Weight Capacity of Elevator: ___________________________________________
(Go to Page 2)