Customer Name:       Pick-Up/Delivery Date:     

Pick-Up/Delivery:        Delivery Pick-Up                       Method of Payment:      Check Credit Card Cash On Account

Delivery Address:    

Job Name/PO:                   Email:       

Contact Name:     Contact Telephone/Pager:   

    *Please Note: You may copy and paste your list of material into the below box from another document (may 

      then need to re-align columns) or you may type directly into the box. 

    List: Quantity / Plant / Size / Comments

    Comments / Instructions / Delivery Directions

• The customer is responsible for unloading.

• Customers must provide reasonable unloading areas that are accessible to our trucks and trailers.

• Customers must provide a physical address and directions to the job site.

• Any person who signs the delivery document has authorization to receive product.

• Local deliveries: $50.00