Contact Information  
Your name:
Your company name:
Address:
City:
State: Zip:
Phone:
Cell: Fax:
Email:
Are you the...
How did you hear about HA?
Referred by:
Do you have an HA Rep:
Who is your HA Rep?
Will you be shipping items purchased from an auction or liquidator?
Load Origin  
Shipper:
Address:
City:
State: Zip:
Phone:
Contact:
Earliest P/U: (dd/mm/yyyy)
Latest P/U: (dd/mm/yyyy)
Does shipper have:
Special requirements:
Load Destination  
Receiver:
Address:
City:
State: Zip:
Phone:
Contact:
Earliest delivery: (dd/mm/yyyy)
Latest delivery: (dd/mm/yyyy)
Does receiver have:
Special requirements:

item descriptions & dimensions (list each piece if multiple items)  

Item 1              
Lot Item/# Description/Make/Model
Length: Width: Height: Wheel Base:
Declared Value: Budget:        
Item 2              
Lot Item/# Description/Make/Model
Length: Width: Height: Wheel Base:
Declared Value: Budget:        
Item 3              
Lot Item/# Description/Make/Model
Length: Width: Height: Wheel Base:
Declared Value: Budget:        
Item 4              
Lot Item/# Description/Make/Model
Length: Width: Height: Wheel Base:
Declared Value: Budget:        
Item 5              
Lot Item/# Description/Make/Model
Length: Width: Height: Wheel Base:
Declared Value: Budget:        

Are the above measurements in feet or inches?

* If dimensions are not given we will use book weight & dems for transportation. All rates are per above dimensions; any change from these dimensions may change the rate accordingly. State or local government requirements resulting in changes in routing or any different or additional service provided by carrier shall result in a change of total charges.

If no declared value. All quotes are based on an industry standard of $100,000 cargo insurance. Cargo insurance is subject to insured's tariff which has maximum liability of $1.00 per pound on used equipment and $2.5 per pound on all other cargo, if additional insurance is needed we must be notified in writing and per telephone call to assure proper cargo insurance is in place for the above described load or loads before movement.

Optional Value Added Services Available:
Type of Service: :

Teardown/Disassembly
Re-Assembly
Steamcleaning
Customs Broker Svcs.
Containerization
20’ Ocean Container
40’Ocean Container
40HC Ocean Container
Roll-On/Roll-Off (RORO)
Heavy-Haul
Project Shipping
Overdimensional Rail
Crane/Rigging
USA/Mexico/Canada
Import/Export
Transloading
Other
Full Value Replacement Coverage

   
List any type of equipment
preferred/required:
List any special securements
preferred/required:
Is tarping required?
Special Instructions or comments