Order Form

New Order
Service
Site Shift
Breakdown
Delivery/Pickup
Quote
Site Inspection
Order Taken by
Order Date
Ordered by?*
Contact Number*
Company Name*
Purchase Order No.
Email*
State
Account Type
Credit Account
Cash Account
Pending approval
Site Contact Name*
Site Contact Number*
Delivery Date*
Delivery Time*
Delivery Address*
Special Delivery Requirements*
Site Conditions
Slab concrete
Rough Terrian
Suspended Slab
Indoor
Non-marking Tyres
Other Site Conditions
Details/Gradients/Weight Restrictions
Hire Start Date*
Site Inspection Completed
Yes
No
N/A
Expected Off Hire Date*
Customer To Pick Up
Yes
No
Auto Off-Hire & Pickup*
Yes No
If yes, When?*
Do the Operators have necessary licensing/training
Yes
No
If No, Is Training Requires?
Yes
No
Are Harenesses Required?
Yes
No
Harness Qty
Machine
Qty
1230ES
1930ES
2030ES
2046ES
2530ES
2546ES
2558ES
3232ES
3246ES
3258ES
Compact 14
M3359
M4059
25RT
32RT
40RT
43RT
53RT
60RT
3084 Speed Level Hybrid
3084 Speed Level Diesel
Machine
Qty
PB1380
Gold Lift
PB1575
PB1890
PB2210
Omme 2750
Omme 3000
Omme 3150
Omme 3700
Gold Lift traller
Scissor Lift traller
TZ34 Towable
TZ50 Towable
Star 8
Star 10
GR20
AM15
AM30Quick Up12
Lift Pod
Track Mats
Duct Lifter
Machine
Qty
30 Electric Knuckle
34 Electric Knuckle
40 Electric Knuckle
45 Electric Knuckle
M600 Electric Straight
Nifty HR12
Nifty SD210
Generator 5KVA
Generator 8KVA
Generator 20KVA
Generator 80KVA
Generator 137KVA
Light Tower LED6
Compressor
Air Hoses
Welder
Weld Lead/Earth Leads
Forklift 2.5t Container
Forklift 2.5t 6m Mast
Forklift Buggy 2.5t
Forklift Buggy 3.0t
Forklift other .....
Slippers
Rotators
Machine
Qty
34 Diesel Knuckle
45 Diesel Knuckle
45/46 Diesel Straight
51 Diesel Knuckle
60 Diesel Knuckle
65/66 Diesel Straight
67 Diesel Straight
80 Diesel Knuckle
85/86 Diesel Straight
100 Diesel Knuckle
135 Diesel Knuckle
135 Diesel Straight
150 Diesel Straight
185 Diesel Straight
Telehandlers 2.5t
Telehandlers 3.0t
Telehandlers 35/3510
Telehandlers 4010
Telehandlers 4013/14
Telehandlers 4017
Telehandlers 6010
Slippers
Jlb
Bucket
Rotator

Other Equipment
Can Customer take larger/other unit?*
Yes No
If yes, what can they take?*