Requested Pick Up Date:... / /. Requested Delivery Date:... / / Street:. Street:... Suburb/Town:.. Suburb/Town:.. Up Down Straight Up Down Straight

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1 QUOTATION REQUEST FORM Page 1 Name:... Mobile:... Phone: Pickup Details Delivery Details Requested Pick Up Date:... / /. Requested Delivery Date:... / / Pick Up From: Deliver To: Street:. Street:... Suburb/Town:.. Suburb/Town:.. Postcode:. Postcode: Driveway Incline Driveway Incline Up Down Straight Up Down Straight Access Details: Access Details: Distance from House to Road in Metres:.. Any Parking Restrictions: EG: Overhanging power wires, low hanging trees, bushes growing into path of driveway etc: Distance from House to Road in Metres:.. Any Parking Restrictions: EG: Overhanging power wires, low hanging trees, bushes growing into path of driveway etc: Packing Required by Offners Removals: Supply Cartons Required: Estimate of Cartons: Large: Small:.. Insurance can be arranged or advised: Any Special Requirements? EG: Large/Heavy items dismantle or reassembly required? Pianos, Pool Tables, large office desks.

2 QUOTATION REQUEST FORM Page 2 To carry out your removal economically and efficiently it is important to provide as much information as possible when filling out the following inventory. Abbreviations are used in the following pages, please circle where applicable. S Small M Medium L Large Lounge/ Family Full Lounge Suite (3 + 2) Lounge/ Family Dining Room Kitchen Laundry Bookcase Large Dining Table Fridge Small Washing Machines Lounge 2 Seater Lamps / Shades Dining Chairs Fridge Large Clothes Dryers Lounge 3 Seater Standard Wall Unit Buffet / Sideboard Freezer Chest Clothes Horses Sofa Bed Large Wall Unit Wall Unit Freezer Upright Brooms/Mops etc Lounge Chair Single Coffee Table Medium Corner TV Unit Heaters / Coolers Dishwasher Laundry Baskets China Cabinets Bookcases Tables Laundry Trolley Armchair Buffet / Hutch Bar Chairs Ironing Board Footstool / Pouffe Low Line Cabinet Tray Mobile Microwave Buckets Video / DVD Players Paintings China Cabinets Kitchen Dresser Single Wardrobe T.V Small Pictures Rugs Tidy Double Wardrobe T.V Large Heaters / Coolers Paintings Stools Tables T.V Extra Large (Plasma or LCD) Writing Desk Pictures High Chair CD / DVD Tower T.V Small Heaters T.V Large Pictures Video / DVD Players Number of Cupboards Pantry Number of cupboards Kitchen Mirrors Occasional Table Side by Side Double Door Fridge Vacuum Cleaner Hall Wine Rack Piano / Organ Piano Stool Pool Table Floor Mats/Rugs Stereo Speakers Bean Bags Hall Stand Hall Table Phone Table Grand/F Clock Pedestal Rugs & Mats Shoe Box Hat Stands

3 QUOTATION REQUEST FORM Page 3 Main Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Wardrobe Single Wardrobe Single Wardrobe Single Wardrobe Single Wardrobe Double Wardrobe Double Wardrobe Double Wardrobe Double 3 Piece Wardrobe Dressing Table Medium Dressing Table Medium Dressing Table Medium (Includes Dressing Table) Dressing Table Medium Dressing Table Large Dressing Table Large Dressing Table Large Dressing Table Large Single Bed Head & Foot Single Bed Head & Foot Single Bed Head & Foot King Bed Head & Foot King Single Bed King Single Bed King Single Bed Queen Bed Head & Foot Queen Bed Head & Foot Queen Bed Head & Foot Queen Bed Head & Foot Queen Ensemble Queen Bed Ensemble Queen Bed Ensemble Queen Bed Ensemble Chest of Drawers Small Chest of Drawers Small Chest of Drawers Small Chest of Drawers Small Chest of Drawers Large Chest of Drawers Large Chest of Drawers Large Chest of Drawers Large Bedside Tables Bedside Tables Bedside Tables Bedside Tables Bedside Chest Bedside Chest Bedside Chest Bedside Chest Chairs Chairs Chairs Chairs Tallboys Tallboys Tallboys Tallboys Lowboys Lowboys Lowboys Lowboys Blanket Box Blanket Box Blanket Box Blanket Box Porta-Robes Porta-Robes Porta-Robes Porta-Robes TV & DVD Bookcases S M L Bookcases S M L Bookcases S M L Desk S M L Desk S M L Desk S M L TV & DVD TV & DVD TV & DVD Cot / Porta Cot Change Table Childs Pram

4 QUOTATION REQUEST FORM Page 4 Office Other Items Shed & Outside Shed & Outside Shed & Outside Desk Small Sewing machines Hand Mower BBQ Small Welder Desk Medium Vacuum Cleaners Ride On Mower BBQ Large (Multiple Burners) Air Compressor Desk Large Suitcases Whipper Snipper Dog Kennel Small Ladders Computer Desk Extra Wardrobes Blowers / Vacuums Dog Kennel Large Wheel barrow Filling Cabinet 2 Extra Filling Camping Gear / Dog Beds Car Ramps Drawer Cabinets Tents Filling Cabinet 4 Garden Tools Extra Computers Golf Clubs / Buggies Animal Cages Drawer (Shovels & Rakes) Bookcases S M L Extra T.V s Push Bikes Outside Tables Small Sawhorses Chairs Trolleys Motor Bikes Outside Tables Large Work Bench S M L Cupboard Small Toy Boxes Weight Bench Outside Chairs Car Parts Cupboard Large Fish Tanks Weights 2 Person Slated Garden Bench Seats Tool Boxes Computer Systems Fishing Rods Boxing Bags Folding Chairs Compost Bins Fax Machine Skies Gym Equipment Trampoline Small Garbage Bins Sofa Lounge Toy Prams Walking Machine Trampoline Large Small Pots Toy Cots Exercise Bike Swing Sets Medium pots Dolls House Eskies Plastic Slide Large Pots Beach Umbrellas Table Tennis Table Cubby House Garden Ornaments Surf Boards Wine Barrels Toy Cars Bird Baths Guitars Hoses Drum Kits Baby Baths Bassinette & Stand Fans Wine Racks

5 QUOTATION REQUEST FORM Page 5 Please also fill in any other big items or valuable items not currently listed in the form. E.g. Ride on Lawn Mower Other Items Other Items Other Items Other Items Other Items Additional Notes: Please send Quotation Request Form to Payment Options Offners Removals Bank Cheque, Cash and EFT Fax: (02) Payments accepted with invoice number attached. Post: PO Box 574, Orange NSW 2800 BSB Account No sales@offnersremovals.com.au Acc Name - Offners Removals Bank - NAB