TEST Delivery & Installation Request Form P.O. Number*Consumer Contact Name* First Last Consumer Cell Phone*Consumer Email* Requested Date of Delivery MM slash DD slash YYYY Delivery Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Who will be paying delivery fees?DealerBuilderConsumerIs this an Inside Delivery (uncrate and set in place)?*NoYes(Additional charges will apply)Please list products being delivered, or attach order*FileMax. file size: 10 MB.Will existing products need to be removed?*NoYesWill AFS be installing the appliances?*NoYesDo you require an AFS Installation quote?*NoYesWho will be paying installation fees?DealerBuilderConsumerNumber of steps that need to be traversed? (Type 0 if none)*Is a spiral staircase involved?NoYesIs there a center island in the kitchen that will be in the way?NoYesAre there any height or width restrictions that will hinder delivery?*NoYesIf yes - please describe:Contact to set up delivery &/or installation?DealerBuilderConsumerName of Dealer*Dealer Contact ( Name & Phone Number):*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.CAPTCHA Δ
