Request for Quote
Company Name:
Name:
Phone:
E-Mail Address:
Customer Reference:
PO Number:
Origin Zip:
Residential Address?
Yes
No
Destination Zip:
Residential Address?
Yes
No
How did you hear about us?
Existing Customer
Magazine
Newspaper
Television
Tradeshow
Recommendation
Internet
Other
Service Level
Threshold
Room of Choice
White Glove
Standard B2B
Items
Line
Custom?
Packaging Type
Description
Length
(in)
Width
(in)
Height
(in)
Weight
(lbs)
Quantity
Total Cube(ft
3
)
1
Blanket Wrap
Carton
Armoire (Large)
Armoire (Medium)
Armoire (Small)
Baby Changing Table
Baby Crib (Frame)
Baby Crib (Mattress)
Baby High Chair
Baby Play Pen
Baby Stroller
Bar
Bar Stool
Bed - Double (Box Spring)
Bed - Double (Footboard)
Bed - Double (Headboard)
Bed - Double (Mattress/Pillow Top)
Bed - Double (Mattress/Standard)
Bed - Double (Set of Rails)
Bed - Queen Size (Boxspring)
Bed - Queen Size (Footboard)
Bed - Queen Size (Headboard)
Bed - Queen Size (Mattress/Pillow Top)
Bed - Queen Size (Mattress/Standard)
Bed - Queen Size (Set Rails)
Bed - Twin Size (Boxspring)
Bed - Twin Size (Footboard)
Bed - Twin Size (Headboard)
Bed - Twin Size (Mattress/Pillow Top)
Bed - Twin Size (Mattress/Standard)
Bed - Twin Size (Set of Rails)
Bed Footboard (Full)
Bed Footboard (King)
Bed Footboard (Queen)
Bed Footboard (Twin)
Bed Frame (Metal)
Bed Headboard (Full)
Bed Headboard (King)
Bed Headboard (Queen)
Bed Headboard (Twin)
Bed Rails
Bench (Wooden)
Bicycle
Book Case (Large)
Book Case (Medium)
Book Case (Small)
Boxes
Boxspring (Full Size)
Boxspring (Queen Size)
Boxspring (Twin Size)
Breakfront
Buffet
Cabinet (Curio)
Cabinet (Wooden)
Cabinet (w/ Glass)
Car Part ( Door/Boxed)
Car Part (Engine/Palletized)
Car Part (Fender/Boxed)
Car Part (Hard Top/Boxed)
Car Part (Hood/Boxed)
Car Part (Tire)
Car Part (Transmission/Palletized)
Carpet (Rolled)
Chair ( Recliner)
Chair (Desk)
Chair (Dining/Arms)
Chair (Dining/No Arms)
Chair (Glider)
Chair (Occasional)
Chair (Open Arm)
Chair (Overstuffed)
Chair (Papasan)
Chair (Rocker)
Chair (Straight Back)
Chair (Wing)
Chaise Lounge
Chest
Chest (Cedar)
Chest (Highboy)
Chest (Lingerie)
Chest (Lowboy)
Chest (Toy)
Chest/T all
China Cabinet (1 piece)
China Cabinet (Base)
China Cabinet (Top)
Clock (Grandfather)
Clock (Grandmother)
Copier (Full Size)
Copier Stand
Corner Cupboard (Large)
Corner Cupboard (Small)
Couch (2 Cushion)
Couch (3 Cushion)
Couch (4 Cushion)
Couch (Sectional/Section)
Couch (Sleeper)
Credenza
Desk (Childs)
Desk (Computer)
Desk (Large)
Desk (Medium)
Desk (Metal Office)
Desk (Roll Top/Large)
Desk (Roll Top/Small)
Desk (Secretary)
Desk (Table)
Desk (Wooden/Exec.)
Dishwasher
Dresser (3 Drawer)
Dresser (4 Drawer)
Dresser (5 Drawer)
Dresser (Double)
Dresser (Triple)
Dryer (Gas or Electric)
Entertainment Cntr (Large)
Entertainment Cntr (Small)
Exercise Equip. (Bike)
Exercise Equip. (Bowflex)
Exercise Equip. (Elliptical)
Exercise Equip. (Rowing Mach.)
Exercise Equip. (Stairmaster)
Exercise Equip. (Treadmill/Folding)
File Cabinet (2 Drawer)
File Cabinet (4 Drawer)
Futon Frame (Full Size)
Futon Frame (Queen Size)
Futon Mattress (Full Size)
Futon Mattress (Queen Size)
Generator (Boxed)
Glass Top (Boxed)
Gun Cabinet
Hall Tree
Hutch (1 piece)
Hutch (Base)
Hutch (Top)
Keyboard (Musical)
Lamp (Table/Boxed)
Lawn Mower (Power)
Marble Top (boxed)
Mattress (King Size/Pillow Top)
Mattress (King Size/Standard)
Mattress (Queen Size/Pillow Top)
Mattress (Queen Size/Standard)
Mattress (Twin Size/Pillow Top)
Mattress (Twin Size/Standard))
Microwave Oven (Large)
Microwave Oven (Small)
Microwave Stand
Mirror (Boxed)
Organ (Med. less than 500 lbs)
Organ (Musical)
Organ (Small less than 200 lbs)
Organ (Small less than 300 lbs)
Organ (Speakers/Leslies)
Organ Bench
Organ Stool
Organ pedals
Ottoman
Patio (Chair)
Patio (Dining Table)
Patio (End Table)
Patio (Lounge Chair)
Piano (Artist Grand)
Piano (Baby Grand)
Piano (Concert Grand)
Piano (Console)
Piano (Consolette)
Piano (Full Grand)
Piano (La Petite Grand)
Piano (Parlor Grand)
Piano (Player Upright)
Piano (Player)
Piano (Professional Grand)
Piano (Semi-Concert)
Piano (Spinet)
Piano (Square Grand)
Piano (Studio)
Piano (Upright grand)
Piano (Upright)
Piano Bench
Printer (Laser Jet)
Refrigerator (Dorm)
Refrigerator (Side by Side)
Refrigerator (Single Door)
Refrigerator (Wine)
Rug (Large/Rolled)
Rug (Medium/Rolled)
Rug (Small/Rolled)
Screen (3 Panel)
Secretary Desk (1 piece)
Secretary Desk (Base)
Secretary Desk (Top)
Server (Dining Room)
Sewing Machine Cabinet
Sideboard
Sofa (2 Cushion)
Sofa (3 Cushion)
Sofa (4 Cushion)
Sofa (Sectional/EACH Section)
Sofa (Sleeper)
Speaker (Floor)
Suitcase
TV (19" to 42")
TV (42"and Up)
TV (Flat Screen/30" to 49")
TV (Flat Screen/50" and Up)
TV (Flat Screen/Up to 29")
TV (Portable)
TV Stand
Table (Cocktail)
Table (Coffee)
Table (Dining Room)
Table (Drop Leaf)
Table (End)
Table (Kitchen)
Table (Lamp)
Table (Night)
Table (Occasional)
Table (Sofa)
Table Top (Glass/Boxed)
Tea Cart
Tool Chest
Treadmill
Trunk
Vacuum (Upright)
Vanity
Washing Machine
1
1
1
1
0
Valuation
Valuation Coverage
$
Additional Valuation Declined
Deductible
$750 Deductible at $10 per $1000 of value
$500 Deductible at $15 per $1000 of value
$0 Deductible at $20 per $1000 of value
Please check all that apply.
Assembly Required
Crating Required
Packaging Required
Unpackaging Required
Stair Carry
Number of Flights
Notes