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Customer Information
Company Name:
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Name:
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Email:
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Phone (Area Code, Exchange, Extension):
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Shipment Information
Trailer Load or Less Than Truck Load:
*
Trailer Load
Less Than Truck Load
Weight:
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Number of Pallets:
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Tailgate Required:
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Yes
No
Pick Up Location:
City:
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Ajax
Brampton
Burlington
Hamilton
Markham
Milton
Mississauga
North York
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Oshawa
Pickering
Richmond Hill
Scarborough
Toronto
Vaughan
Whitby
Postal Code:
Request Pickup Date:
*
Are appointments required for pickup:
*
Yes
No
Delivery Location:
City:
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-- Select One --
Ajax
Brampton
Burlington
Hamilton
Markham
Milton
Mississauga
North York
Oakville
Oshawa
Pickering
Richmond Hill
Scarborough
Toronto
Vaughan
Whitby
Postal Code:
Requested Delivery Date:
*
Are appointments required for delivery:
*
Yes
No
Comments:
If there are any special requirements or instructions, please note them in the space provided below.