*= must answer

GENERAL QUESTIONS

Anticipated project date?: *

First name?: *

Last name?: *

Your direct phone number?: *

Your email address?: *

Are you the point of contact?: *
YesNo

Full company name?: *

General company phone number?: *

Full company address?: *

City?: *

State?: *

Zip code?: *

Is the company above responsible for payment?: *
YesNo

Project managers name?: *

Project managers direct phone?: *

Project managers email?: *

Complete project origin address #1: *

Project origin address #2: (If any)

Project destination address #1: *

Project destination address #2: (If any)

What are your insurance requirements?: *

Please list each piece of equipment to be moved *

- or upload your inventory file or photo here:

Please list number of rack(s) to be moved from the origin to the destination *

Do the rack(s) have casters?: *
YesNo

Would you consider a populated move? (Equipment stays in rack while moved): *
YesNo

Do you require moving project management?: *
YesNo

Do you require moving consultation services?: *
YesNo

Do you require equipment inventory services?: *
YesNo

Do you require equipment asset tagging services?: *
YesNo

Do you have a current Disaster Recovery Plan and backup capabilities in place?: *
YesNo

ORIGIN QUESTIONS

Do you require us to remove wires and cables at the origin?: *
YesNo

Do you require us to de-rack (remove equipment from racks) at the origin?: *
YesNo

Do you require us to package the equipment at the origin?: *
YesNo

What floor is the origin equipment located on?: *

Are elevators available at the origin if required?: *

How many stairs are there at the origin that the equipment must travel over?: *

Are there additional encumbrances at the origin? (floor gaps, door heights etc): *
YesNo (If “yes” please describe on box below)

Does the origin have truck docks?: *

Will a lift gate truck be required at the origin?: *
YesNo

Does the origin require COI’s, dock tickets or service tickets?: *
YesNo

DESTINATION QUESTIONS

Do you require us to re-rack (Put equipment back in the racks) at the destination?: *
YesNo

Do you require us to package the equipment at the destination?: *
YesNo

What floor is the destination equipment located on?: *

Are elevators available at the destination if required?: *

How many stairs are there at the destination that the equipment must travel over?: *

Are there additional encumbrances at the destination? (floor gaps, door heights etc): *
YesNo (If “yes” please describe on box below)

Does the destination have truck docks?: *

Will a lift gate truck be required at the destination?: *
YesNo

Does the destination require COI’s, dock tickets or service tickets?: *
YesNo

How did you locate us?: *
GoogleYahooBingOther

What keyword did you use to locate us?: *

Area for additional notes and information: