COMPANY CONTACTS SERVICES LINKS  

 

 

Pickup Request Form

 

Requested By

Please provide your contact Info: (* indicates required field)

*First Name:  
*Last Name:  
*Company:  
*Phone:  
*Fax:  
Email:  
*Payment Method:  

Pick Up Location (Shipper)

*Company:  
*Address:  
*City:   *State:   *Zip:  
*Contact:  
*Phone:  
Fax:  
Email:  
Pickup Date:  
*Shipment References:  
*Time Ready:  
*Close Time:  
Type of Pickup:  
Lift Gate Needed?  

 Delivery Location (Consignee)

Check here if same as Requested By (above)  
*Company:  
*Address:  
Address:  
*City:   *State:   *Zip:  
*Contact:  
*Phone:  
Type of Delivery:  
Lift Gate Needed?  

Commodity

Total Number of pieces:  
Total Weight:  
Commodity:  
Total Cubic feet:  

Measurements:

  Length Width Height
1st pcs
2nd pcs
3rd pcs
4th pcs

Note:

 

                                                             3350 SW 148 Ave. Suite 110 Miramar, FL 33027-3237    Copyright 2011 FVL Inc.   Phone (954) 699-0172   Fax (888) 600-3427   Send Email to INFO

                                                               Updated: 12 Oct 2011           Site Designed by Bill Gerdts          Site Maintained by: The Anchor ConsultingGroup, Inc.   Contact WebMaster