TEST Drop Ship Request Form P.O. Number*Requested Date of Delivery* COMNET Order NumberChoose one:HomeownerSalespersonOtherContact Name* First Last Delivery Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Cell Phone*Email* Is Job Site Paved?*YesNoIs the egress safe?YesNoObstructions (please mark all that apply) Planking Mud Snow Debris Low Wires Sand Ice Gravel Please explain any other hazards that may affect delivery?Is this an Inside Delivery (uncrate and set in place)?YesNo(Additional charges do apply)If yes - Please describe product being delivered inside: Please choose which type of job siteNew ConstructionRemodelMulti-tenant HousingIf Multi-tenant building, is there a freight elevator to use?YesNoIf yes - please provide door and interior space dimensions Number of steps that need to be traversed? (Type 0 if none)* Is a spiral staircase involved?YesNoAre there any special flooring considerations that need to be addressed?Are there any height or width restrictions that will hinder delivery?*Is there a center island in the kitchen that will be in the way?YesNoName of Dealer Submitted by: An additional charge will be assessed if the information contained in this document does not correlate to onsite conditions. *Builder or Homeowner must have egress cleared of ice/snow/obstacles. Trevarrow, Inc. reserves the right to cancel a delivery that is deemed unreasonable or unsafe.