ELITE MOVING Long Distance Delivery Information Long Distance Delivery Information - NOT DO DELETE "*" indicates required fields To start your delivery process, Please fill in the form below. Any wrong or missing information may cause a delay in the delivery time and additional charges may be applied.Customer's Name*Job NumberPrimary Phone*Emergency Contact PhoneEmail* Moving To* Street Address Unit Number City State / Province / Region ZIP / Postal Code Delivery Entrance*Please selectHouseGround LevelStairsElevatorNumber of Floors12345If you like on the second floor or higher, there may be an additional cost.Do you have an extra stop? Yes No Please provide address of the additional stop* Street Address Unit Number City State / Province / Region ZIP / Postal Code Delivery Entrance*Please selectHouseGround LevelStairsElevatorNumber of Floors12345If you like on the second floor or higher, there may be an additional cost.Will you be present at delivery? Yes No NamePlease give us the name and number of the person who will be presentPhoneCan we access and park 53' trailer (72' bumper to bumper)? Yes No Can we park within 75' from your apartment door / house door? Yes No Additional charges may apply.How far can we park?Any additional notes for us?Select First Available Date* MM slash DD slash YYYY Consent*Long Distance Delivery Terms: Our rates are based on our ability to deliver anytime (Mon-Sun 7am-9pm) within the delivery window listed below with a notice by 6pm day prior to the arrival. Notify Elite in writing if there are any restrictions at the delivery, prior to setting up the 1st available delivery date, AND you must receive a written confirmation back with the approval of these restrictions. Any restriction on the hours and/or days will void the delivery window and may cause additional charges. The driver will contact you with the ETA by 6pm the day prior to the delivery. Your Delivery Window starts from the 1st available delivery date specified by you in this document: Delivery window: Mid-West to Mid-West, West Coast & East Coast: 1-14 business days. Coast to Coast, VT, NH, ME, ID, WY, SD, ND: 1-21 business days. All deliveries are made on a flexible basis. Delays caused by weather, acts of God, civil unrest, and other events beyond the control of Elite Moving & Storage Inc. shall not be the responsibility of Elite Moving & Storage Inc. The balance due should be paid before unloading, by cash or postal money order only. Without it we will not unload the shipment. In the event of the customer’s inability to receive the shipment at the time of delivery, the shipment will be placed in storage and will be redelivered on a later date, at customer’s expense. I have read and accept the long-distance delivery terms in this document*Consent* Charges:Stairs - In a single-family home, Multi-family home and apartment building: one (1) flight is seven (7) stairs. 1st flight (7 stairs) is Free. Each additional flight (of 7 stairs) is $75.00Waiting Time - Anytime that the truck and/or crew are waiting to deliver for one hour, the cost is $190.00 per hour per vehicle. Overnight wait: $1,500.00 per night (7pm-7am)Long Carry – Distance between the truck / trailer to the living quarters (example: parking lots, crossing lawns, lobby and hallway in apartments building). Cost: 1st 75’ is Free. Each additional 75’ feet is $75.00Shuttle - When the truck/trailer cannot fit safely in the alley or street, it is at the driver’s discretion whether to conduct a long carry service or use a smaller size truck (shuttle) in order to get as close to the residence as possible. Shuttle rates of $1.00 per cubic foot (i.e. 325 cubic feet = $325) I have read and accept the additional charges that may apply at the delivery*SignaturePhoneThis field is for validation purposes and should be left unchanged. Δ