CUSTOMER INFORMATION ENQUIRY FORM€¦ · Piano Mirror Sideboard Piano Stool Piano - Upright...
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CUSTOMER INFORMATION ENQUIRY FORM DATE: OFFICE REP NAME PHONE VIEWED ENGLISH AFRIKAANS SOURCE NAME: POSTAL ADDRESS: TEL: WORK TEL: HOME COLLECTION ADDRESS: CELL NUMBER: FAX NO: DELIVERY ADDRESS: E-MAIL: CONTACT ADDRESS: DATE OF COLLECTION: IS DATE FLEXIBLE? YES NO CAN WE DO ALL YOUR PACKING: YES NO BREAKABLES YES NO WHO WILL BE PAYING OUR ACCOUNT SELF COMPANY/DEPT NAME OF PERSON MOVING INTO RESIDENCE TEL NO: NAME OF PERSON MOVING OUT OF DELIVERY ADDRESS TEL NO: IS ACCESS TO RESIDENCE EASY COLLECTION DELIVERY BIDDULPHS RECOMMENDS THAT YOU HAVE TRANSIT INSURANCE, PLEASE ADVISE THE VALUE IF WE ARE TO ARRANGE: DO YOU HAVE FLAT SCREEN TELEVISIONS? PLEASE CIRCLE ITEMS ON THE INVENTORY PAGE THAT YOU WOULD LIKE US TO SPECIALLY WRAP PLEASE COMPLETE INVENTORY ON NEXT PAGE SIZE OFFICE USE ONLY QUOTE NO VAT TOTAL REMOVAL FROM TO R TO R TO R FUEL SURCHARGE @ % R STORAGE PER MONTH R STORAGE INSURANCE PER MONTH R PACKING PER CARTON R R R INSURANCE % ON R R PRICE APPROVED BY (ALL INCLUSIVE MOVES) TOTAL R REMARKS BOOKING FORM PRE PACK DATE DATE OF COLLECTION PACKING MATERIALS DATE OF DELIVERY STD CARTONS BOOK CTNS RECHECK ADDRESSES AND TELEPHONE NOS W/CARTONS LINEN CTNS PAYMENT OF ACCOUNT PLASTIC D K/S SELF COMPANY CRATING PIC BAGS SIGNED QUOTE YES NO C.CARDS F/SHEET INS VALUATION FORM YES NO L/S COVERS X2 X1 OTHER SPECIAL INSTRUCTION FOLLOW UPS CREDIT APPROVAL PRE PACK DATE COMPANY NAME APPROVED BY ON ACCOUNT PHONE NO COMPANY CHEQUE ON DEL ________________ PERSON TO SPEAK TO ______________________________________________________________ CUSTOMER TO SEND ORDER _________________________________ O/NO ______________ CASH ON DELIVERY _______________________ / / ____________ BASIC / / X3 S 0
Transcript of CUSTOMER INFORMATION ENQUIRY FORM€¦ · Piano Mirror Sideboard Piano Stool Piano - Upright...
CUSTOMER INFORMATION
ENQUIRY FORM DATE:
OFFICE REP NAME PHONE VIEWED ENGLISH AFRIKAANS SOURCE
NAME:
POSTAL ADDRESS: TEL: WORK
TEL: HOME
COLLECTION ADDRESS: CELL NUMBER:
FAX NO:
DELIVERY ADDRESS: E-MAIL:
CONTACT ADDRESS:
DATE OF COLLECTION: IS DATE FLEXIBLE? YES NO
CAN WE DO ALL YOUR PACKING: YES NO BREAKABLES YES NO
WHO WILL BE PAYING OUR ACCOUNT SELF COMPANY/DEPT
NAME OF PERSON MOVING INTO RESIDENCE TEL NO:
NAME OF PERSON MOVING OUT OF DELIVERY ADDRESS TEL NO:
IS ACCESS TO RESIDENCE EASY COLLECTION DELIVERY
BIDDULPHS RECOMMENDS THAT YOU HAVE TRANSIT INSURANCE, PLEASE ADVISE THE VALUE IF WE ARE TO ARRANGE:
DO YOU HAVE FLAT SCREEN TELEVISIONS?
PLEASE CIRCLE ITEMS ON THE INVENTORY PAGE THAT YOU WOULD LIKE US TO SPECIALLY WRAP
PLEASE COMPLETE INVENTORY ON NEXT PAGE SIZE
OFFICE USE ONLY
QUOTE NO VAT TOTAL
REMOVAL FROM TO R
TO R
TO R
FUEL SURCHARGE @ % RSTORAGE PER MONTH R
STORAGE INSURANCE PER MONTH R
PACKING PER CARTON RR
R
INSURANCE % ON R R
PRICE APPROVED BY (ALL INCLUSIVE MOVES) TOTAL R
REMARKS
BOOKING FORM
PRE PACK DATE
DATE OF COLLECTION PACKING MATERIALS
DATE OF DELIVERY STD CARTONS BOOK CTNS
RECHECK ADDRESSES AND TELEPHONE NOS W/CARTONS LINEN CTNS
PAYMENT OF ACCOUNT PLASTIC D K/S
SELF COMPANY CRATING PIC BAGS
SIGNED QUOTE YES NO C.CARDS F/SHEET
INS VALUATION FORM YES NO L/S COVERS X2 X1
OTHER SPECIAL INSTRUCTION
FOLLOW UPS
CREDIT APPROVAL
PRE PACK DATE
COMPANY NAME APPROVED BY
ON ACCOUNT
PHONE NO COMPANY CHEQUE ON DEL ________________
PERSON TO SPEAK TO ______________________________________________________________
CUSTOMER TO SEND ORDER _________________________________ O/NO ______________ CASH ON DELIVERY _______________________
/ /
____________
BASIC
/ /
X3
S
0
DATECUSTOMER:
ITEM QTY ITEM QTY ITEM QTYLounge / Living room T.V Room Dining Room Bookcase Bar BookcaseBureau Bar Stool CabinetCabinet Bookcase Carpet/RugCarpet/Rug Bureau CarverChair - arm Cabinet ChairChair - arm(s) Carpet/Rug Cocktail CabinetChest of drawers Chair Cutlery BoxDisplay Cabinet Chair - arm(s) Dining TableHeater/Fan Chest of drawers Grandfather clockHi-Fi/Radio Heater/Fan Heater/FanHi-Fi stand Hi-Fi/Radio Lamp - standKist Hi-Fi stand Lamp - tableLamp -stand Kist MirrorLamp - table Lamp -stand PaintingsMirror Lamp - table ServerPiano Mirror SideboardPiano Stool Piano - Upright TrolleyPaintings Piano - Grand Welsh dresserSettee - one Piano Stool OthersSettee - two PaintingsSettee - three Settee - oneTable - coffee Settee - twoTable - occ. Settee - threeTable - misc. Table - coffee Hall/Passage Television (T.V.) Table - occ. BookcaseVideo/Decoder Table - misc. BureauWall Unit (Sections) Television (T.V.) CabinetOthers Video/Decoder Carpet/Rug
Wall Unit (Sections) Chair(s)Others Chest of drawers
HallstandKistLampMirrorsPainting(s)
Kitchen/Pantry/Laundry Telephone TableStudy Cabinet(s) TableBookcase Chair(s) OthersBureau Clothes HorseCabinet CoolboxCarpet/rug DeepfreezeChair(s) DishwasherChest of drawers DustbinComputer Fridge PatioComputer stand Ironing Board BraaiDesk Ladder Chair(s)Heater/Fan Laundry Box Garden BenchMirror Microwave LoungerPaintings Table TablePhoto Equipment Tumble dryer TrolleyPicture(s) Vacuum cleaner UmbrellaSewing Machine Vegetable Rack Umbrella StandSewing Machine cabinet Washing machine Pot Plants (S)Sleeper couch Others (M)Others (L)
Others
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TOTAL PAGE 1 0
SURVEY LIST
ITEM QTY ITEM QTY ITEM QTYBedroom 1 Bedroom 2 Bedroom 3Bed double Bed double Bed doubleBed(s) single Bed(s) single Bed(s) singleBed headboard Bed headboard Bed headboardBedside table Bedside table Bedside tableBookcase Bookcase BookcaseCabinet(s) Cabinet(s) Cabinet(s)Carpet/rug Carpet/rug Carpet/rugChair(s) Chair(s) Chair(s)Cheval mirror Cheval mirror Cheval mirrorChest of drawers Chest of drawers Chest of drawersCot/compactum Cot/compactum Cot/compactumDesk Desk DeskDressing table Dressing table Dressing tableDumb valet Dumb valet Dumb valetHeater/Fan Heater/Fan Heater/FanKist Kist KistLamp(s) Lamp(s) Lamp(s)Mirrors(s) Mirror(s) Mirror(s)Paintings(s) Painting(s) Painting(s)Stool Stool StoolTable Table TableTelevision (TV) Television (TV) Television TV)Wardrobe(s) Wardrobe(s) Wardrobe(s)Others Others Others
Master Bedroom Playroom Garage / Storeroom /OutsideBed - King size Bookcase BandsawBed(s) - Single Cabinet(s) BinBed headboard Carpet/rug Bicycle(s)Bedside table Chair(s) BraaiBookcase Chest of drawers Cabinet(s)Cabinet(s) Desk Chair(s)Carpet/rug Heater/Fan CompressorChair(s) Hi-fi/Radio EdgetrimmerCheval mirror Lamp(s) Gas BottlesChest of drawers Mirror(s) Golf clubsCot/compactum Painting(s) HosepipeDesk Settee Kennel(s)Dressing table Table LadderDumb valet Tricycle LatheHeater/Fan Toys Lawn MowerKist Television (T.V. ) Motor CycleLamp(s) T.V.trolley Spade/fork/rakeMirror(s) Video Sports equip.Painting(s) Others Swing/folding Safe Table(s)Settee Timber (vol)Stool Tool chestTable Tools Television (TV) Boxes Trunk(s)Wardrobe(s) Books Water FeatureOthers Cutlery Welding Machine
CD's WheelbarrowChina/Crockery Workbench Clothing OthersCurtainsGlasswareGroceriesKichenwareLinenOrnamentsPaintingsOthers
SUBTOTAL 0 SUBTOTAL 0 SUBTOTAL 0
0TOTAL PAGE 1 & 2
