Traffic and Logistics Information Form

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Customer Information

First Name

Last Name

Account #

Shipping Address and Contact Information

Palletized Truck Shipments must deliver to a commercial address. Additional fee will apply for Residential Delivery. Please supply the following Shipping Contact information for the Bill of Lading.
Shipping Location Name
Shipping Address
Shipping City	Shipping State	Shipping Postal Code
Contact First Name	Contact Last Name	Contact Email	Contact Phone #

Receiving Hours

If the location to which we are shipping is not open Monday-Friday, 8am to 5pm, please complete the following: Days/Hours that your Business receives shipments.
Monday:	Opening Time	to	Closing Time
Tuesday:	Opening Time	to	Closing Time
Wednesday:	Opening Time	to	Closing Time
Thursday:	Opening Time	to	Closing Time
Friday:	Opening Time	to	Closing Time

Other Shipping Information

Do you require an appointment? Yes
No

Do you require a Liftgate? Additional fee will apply if Liftgate is needed. Yes
No

Are you a residential delivery? Additional fee may apply for Residential Delivery. Residential: A residential delivery is defined as delivery to a location that is a home, including a business operating out of a home. Yes
No

Traffic and Logistics Acknowledgement

Traffic and Logistics Acknowledgement:

If the carrier attempts but is not able to complete the delivery, your company will be liable for any fees associated with redelivery.
Unless noted on this form, AmChar assumes that we are shipping to a business location and not a Residential location that has normal business hours.
Special delivery instructions must be listed on each order submitted if additional services are needed or if delivery cannot be accepted Monday thru Friday, 8am to 5pm.
Customer is responsible for any additional charges accrued during delivery for but not limited to Liftgate, Residential, Inside Delivery, Redelivery and Delivery appointment.
If an order is being delivered to an address other than the address on this form the Customer on this form is responsible for informing AmChar of any extra needs/services.
If an order is large enough it will be shipped out LTL rather than Parcel at AmChars discretion.

Signature

Print Name

Signed Date