Moving
Date: Number
of Bedrooms:
Do
you need American Movers to do
your packing for you?
Yes
No
Do
you need Packing Supplies?
Yes
No
Stairs?
Origin:
Yes
No
Destination
Yes
No
If,
yes, give total number of
stairs at each:
Origin:
Dest.:
Elevators?
Origin:
Yes
No
Destination:
Yes
No
If yes, give floor number at each location:
(e.g., 24 at origin,
10 at destination)
Origin:
Dest.:
Long
Carrying Distance? Origin:
Yes
No
Destination:
Yes
No
Give
number of feet from truck to
front:
Origin:
Dest.:
Need Replacement value protection?
Yes
No
Local/Intrastate
(CA) = .70 cents per $100.00
Give total dollar value of shipment:
Piano?
Yes
No
If Yes, What type?
Please choose
Grand
Baby
Grand
Upright
Spinet
Overtime
Loading (weekends or after
5pm)
Yes
No
Service
Appliances?
Yes
No
Total #
Need
Storage?
Yes
No
Extra
Stop? Origin:
Yes
No
Destination:
Yes
No
Furniture
List:
Special
Considerations: (Antiques,
pianos, etc.)
Additional
Services: (Stairs,
Elevators, Appliances,
Storage)
E-mail
(required*) Please
be sure to fill in your
complete email address (i.e.
info@americanmovers4u.com ) *If
no e-mail, please leave a
phone number so we may
contact you.
Name:
Address:
City:
Phone:
Home:
Fax:
Check
here if you need an estimate
faxed to you.
