Order Form

To place an order, please complete all sections of this form. You will be contacted by email (if provided) or phone to confirm receipt of your order.

If you have more than 6 pieces of equipment to be moved, please call 866-333-7363 for special pricing options.

Section A - Billing Information

Company Name

Address

City

State

Zip

Phone

Cell

Fax

Email

P.O.#

Contact Name

 

Section B - Equipment Origination

Company Name

Address

City

State

Zip

Phone

Cell

Fax

Email

P.O.#

Contact Name

 

Section C - Equipment Destination

Company Name

Address

City

State

Zip

Phone

Cell

Fax

Email

P.O.#

Contact Name

 

Section D - Equipment Information

Serial # Make Model Color Year Type

Terms & Conditions

All decked loads are subject to toll charges, overweight/oversize permit charges and other charges associated with decked units. If proper decking facilities are not provided at origination (pick up location), wrecker fees may apply. Customer may be responsible for shield, tire and axle removal charges. Dependable is not responsible for reinstalling shields. Units delivered to a vacant (no personnel) facility and no receiving signature is available, any damages or situations will not be the responsibility of Dependable Transport, Inc.

*By submitting this form, sender understands and agrees that the order is active and will be considered a confirmed placement of order.

*By submitting this form, sender agrees to all terms and conditions.