Company Name:
Contact Name:
Contact Phone:
Contact Email:
Pickup Location(s):
Requested Date:
Requested Time:
PC's:
Laptop:
Monitors:
Laser Printers:
Large Laser Printers:
Servers:
Docking Station & Port Replicators:
Scanners:
Terminals:
Inkjet Printers:
Hubs:
Copiers:
Fax Equipment:
Misc. (Mice, Keyboards):
Other:Please Describe
Please Describe
Yes Will you need Hard Drive Erasure?
Yes Is your interest in Recycling ONLY without Asset Management?
Yes Are you interested in the resale of your assets
Yes Does the freight company need a Certificate of Insurance to enter the facility?
Yes Is union labor required to enter the building?
Yes Does location have a dock?
Yes Is a lift gate needed?
Yes Is a pallet jack available?
Yes Is forklift available?
Yes Freight elevator required and will be available?
Yes Photographs allowed?
Yes Certificate of Equipment Removal (transfer of asset) required?
Yes Certificate of recycling required?
Maximum size truck this location can accommodate:
Internal doorway size:
Can hand carts be utilized to transport items to dock/truck?
What are the dock hours?
Where is the equipment located in the building?
Where will the palletizing/shrink-wrapping be done (e.g. dock, parking lot)?