954-772-8500

Supplies Order Form

For Prompt Scheduling; Submit or
Print This Form and Fax, Filled Out To:
Secure FAX 954-475-9005
           PHONE 954-349-1916
 
Full Name:*  
EMail:
Address:
City State Zip:
Home Phone: Work:Cell:
   
Move Date:

ITEM DESCRIPTION PRICE QTY
1.5  12x12x18 Box $2.45
3.0 18x18x18 Box $3.45
4.5 18x18x24 Box $4.35
6.0 20x20x20 Box $6.85
Dish Pack 18x18x27 X/S Box $11.80
Wardrobe 21x24x47 Box w/Bar $14.25
Mirror/Picture Pack Adjustable Box $5.50
White News 50 lb. Bundle $58.00
Small Bubble Small Roll $25.00
Bubble Wrap Large Roll $51.50
Brown Pad One Bundle $56.50
Tape One Roll $3.00
Plastic Wrap One Roll $29.00
Mattress Bag One Bag Single $4.00
Mattress Bag One Bag Full/Queen $5.00
Mattress Bag One Bag King $6.00
Commercial Bin Large Box 3'x3'x4' $24.00
Markers Permanent Black, One $3.50

Method of Payment -    Day of Move    COD    Cash    Check    Credit Card

For Special Packages, Circle Package Number:    1    2    3    4