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A PRICE YOU CAN COUNT ON

ALLIED VAN LINES, INC.' P.O. BOX 4403' CHECK OOTHER OCASH CHICAGO, IL 60680' CARD PHONE (630) 570-3000 OCHARGE
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IF PAID BY GREDITCARO: PACKINGDATE(S) REQUESTED SHIPPER RICK. STAHL AIC LOADINGADDRESS ." 39250
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LOADING OATE(S) REQUESTED--'''-';''-''-''-''''''-_ (6~'l-~38.!'1l'822 CONSIGNEE

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DELIVERV OATE(S)OR PERIOD OFTIME REQUESTED 017 to RICK STAHL ~~j)8-4'S'22 ';0011 AODRESS _-.;;~_-;:=
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BASTILLE
LANE
DELIVERYADDRESS WILL ADVISE CITY,STATE,ZIP l'HDl\W.... TT. -iNOTIFy --I~C~ITY.!!,::.ST!.:AT~E"', Z:::IP ADDRESS STATE
",CI.;.;TV~, S""TA~T",E',;;ZI;:;:P=""",i;Pi;AU~MD~AL=E~-:cC",A~9,",3",5,,,5,,-1"CARRIER'S CONTACTOfFICE AT DESTINATION AGENT CODE NAME CITY COSTOF SERVICES- CARRIER TARIFF ALlV-2A. SEEREVERSEfOR AVAILABILITY. 1.
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APPLICABLE
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CHARGES
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TRANSPORTATION: 3-DIGIT ORIGIN ZIP: 935 3-DIGIT DESTINATION ZIP:JiQ~ EXTRA STOP ZIPS (In Order Of Occurrence): (1) (2) (3) (4) MILEAGE: 1988 EST. WI 1850 LBS., MOVING AS WT: LBS, TRANSPORTATION CHARGE .. ORIGIN SERVICE CHARGE: $
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DESTINATION SERVICE CHARGE: $ ..... ", ................. .............................. VALUATION FOR TRANSPORTATION: PROTECTION SELECTED: CARRIER MINIMUM OF 60 PER POUND PER ARTICLE (NO CHARGE), OR EXTRA CARE PROTECTION PLAN DEDUCTIBLE OPTION: 01.$002.$250 03$500 SHIPPER DECLARED VALUE $ ... ....... .............. ......................................................... .............................. .... , ................... T A) DAILY STORAGE: (WT. __ LBS.) FIRST DAY@ __ PER 100 LBS. + __ ADD'L. DAYS@ __ PER 100 LBS ........ R A B) VALUATION@ % OF TRANSPORTATION VALUATION CHARGE PER 15 DAY PERIODS ....... r N N S C) __ PICK-UP, OR __ DELIVERY: BASE WT. LBS., BASE TRANSPORTATION CHARGE $ ..... .......... I T EXCESS MILES CHARGE ($ ) PER EACH 25 MILtS OR FRACTION OVER 30 MILES:
5.A) BULKY ITEM: (TYPE) $ (IF AUTO): MAKE WT. MODEL YR DIMENSIONS: LENGTH FT. WIDTH FT. HEIGHT FT. B) WEIGHT ADDITIVE: ITEM LENGTH FT. ADDITIVE WEIGHT LBS. (AOD TO EST. WT.) ........................ 6. PACKING AND UNPACKING __ FULL SERVICE PACKING @ $ PER 100 LBS ....... ............................... .... ........................ .......... ... ......... ,... ............... __ FULL SERVICE UNPACKING @ $ PER 100 LBS .................. ............................................ ......... ......................... .... ...... --1!r-CUSTOM SERVICE PACKING (ITEMIZED BELOW) .. MATTANDooxSPRINGONLy __ CUSTOM SERVICE UNPACKING (ITEMIZED BELOW) ...... .. .................. ...... .......................... ............. .. ................ ....... , ........... .......... 7. 8. LABOR EXTRA STOP(S) AT ORIGIN SHUTTLE SERVICE: $ ORIGIN SELF STORAGEIMINI-WHSE DESTINATION SHUTTLE SERVICE: $ ...................................... DELIVERY: $ .......... PICK-UP: $ FUEL SURCHARGE ON TRANSPORTATION: $ 91.95 DESTINATION SELF STORAGEIMINI-WHSE MEN/FOR TRK HRS@$ PER MAN PER HOUR .. .............. , ........................... ...... ..............
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10. 11. 12. 13. 14. 15.
FUEL SURCHARGE ON SIT PICK-UP OR DELIVERY $ TOLLS AND FERRY CHARGES OR OTHER FEES TO THIRD PARTIES WEEKEND, HOLIDAY, OR AFTER HOURS DELIVERY 4 % INSURANCE RELATED SURCHARGE
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I NOTICE:
THIS GUARANTEED PRICE PLEDGE APPLIES ONLY FOR THE SERVICES ORDERED ABOVE, AND THE ITEMS TO BE MOVED AS .SHOWN ON THE CUBE SHEET... .
OUAN. A E f G H
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TOTAL GUAp':c~EEO
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2115
59
COSTOF PACKING & UNPACKINGSERVICE ITEMS BARREL, DISH PACK,DRUM, ETC. CARTONS:LESS THAN 3 CUBIC FEET 3 CUBIC FEET 4-1/2 CUBIC FEET 6 CUBIC fEET 6-1/2 CUBIC FEET WARDROBECARTON,NOT LESS THAN 10 CU. FT. MATIRESS CARTON,CRIB (NOT EXCEEDING39"X75") (NOT EXCEEDING54'X75') (EXCEEDINGS4"X7S") (39"X80") MATIRESS COVER(PLASTIC OR PAPER) CORRUGATEDCONTAINERS CRATES
CONTAINERS RATE AMOUNT
QUAN.
PACKING RATE
AMOUNT
aUAN.
UNPACKING RATE
AMOUNT
L S M
N
18.00
36.00
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CR ~GE
TOE ACK
AND
m/pACK
MATTS
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R TOTAL CONTAINERCHARGES $36.00 TOTAL PACKINGCHARGES
:ADDCONTAINER,PACKING & UNPACKING TOTALS TOGETHER AND INSERT SUM TOTAL ON LINE 9 ABOVE
-0-
TOTAL UNPACKINGCHARGES
PRICE
GUARANTEED
~~T~lliil~~aD~~~~~~~~rrc~~UJurn~~c~~~~somm~~~~~~~~~
R A 3 DAYS LOAD SPREAD IS REQUIRED DUE TO BEING A SMALL SHIPMENT. ONCE A DRlVER IS ASSIGNED. K S I WILL KNOW WHICH DAY HE WILL LOAD AND UNLOAD. PLEASE ALLOW 6-15 DAYS FOR DELIVERY I HEREBYACKNOWLEDGETHAT I HAVE RECEIVEDTHE PAMPHLET CONTAINING "YOUR RiGHTS This Guaranteed Price Pledge is an estimate which is binding upon us ~~~~m~~s1~5ITII~~~~~ ~~~~L~~li"p~~lg~DA~~~ ~~NJAt'~~ ~~~~L~~D~S and you. It applies only for the services ordered above, and the items to be moved as shown on the cube sheet. Any additional services or items required or requested, to be performed or shipped by the shipper, SIGNATURE OF SHIPPER OR REPRESENTATIVE X will be in addition to the tolal price, This total price will be honored for J.--..:.:------------------------I;w-days followin I e ignature. MAIL ACCEPTANCE PROPOSALTO: Of
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Z"93535
CITY
LANCASTER
PAINTED IN THE U.S.A.
1. SHIPPER (CUSTOMER)

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A PRICE YOU CAN COUNT ON

LOADING OATE(S) REQUESTED--'''-';''-''-''-''''''-_ (6~'l-~38.!'1l'822 CONSIGNEE

......... " ............

CONTAINERS RATE AMOUNT

R TOTAL CONTAINERCHARGES $36.00 TOTAL PACKINGCHARGES

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