Test LaserQuik Service Inquiry Company Name Your Name * Required Your Name First First Last Last Email Address * Required Confirm Email Address * Required Please enter email address again Phone Number *Required Company/Billing Address Pick-up Location (please include street address, city and zip code). Drop-off / Destination location (please include street address, city and zip code). Please describe item to be moved/relocated: Mobile Office Container Tiny Home Mobile Home (made after 2000, setup and tear down not available in Washington State) Freight Other (Describe)Other (Describe) For mobile homes, please list year of manufacture (note: LaserQuik does NOT transport mobile homes made before 1976). Item Width Item Height Item Length Item Weight Set-up Services Crawler Work Set-up - Support piers & pads Set-up - Cinderblocks Set-up on Uneven Ground Axle(s) Removal Tongue Removal Trailer Rolling Removal Services Crawler Work Tear-Down - Support piers & pads Tear-Down - Cinderblocks Axle(s) Install Tongue Install Tire Changes How Many Tires to Be Changed? Additional Services - Please describe any additional services you may need Preferred Date & Time of Service Hours of Availability Security Access Does either pick-up or drop-off at a secure site require anything special for access. If so, please check the box and describe:Does either pick-up or drop-off at a secure site require anything special for access. If so, please check the box and describe: Confirmation of Safe Conditions *REQUIRED Job has reasonable route access for the width, length, height & weight of the unit. No overhead obstructions (limbs, wires, etc.). Unit’s placement has reasonable access on all sides. Site conditions will support LaserQuik equipment during the time job has been requested. Contents - Does the unit have any contents inside? * Required Yes - If so, give approx weight & descriptionYes - If so, give approx weight & description No Asset Details Ready to Transport (If not, describe why in comments) Tires - On & Road Ready Frame in Good Condition - Not bent or broken, cross supports good. Brake Wiring Intact Hitch - 2" Hitch - 2 5/16" Hitch - Pintle Tongue Jack Installed - Functional - Fully Retracts Tongue Jack Installed - Not Functional - Will not retract fully Gutters, Downspouts or Other Protrusions. Describe:Gutters, Downspouts or Other Protrusions. Describe: Upload Photos Drop a file here or click to upload Choose File - JPG, PNG, GIF or PDF only Maximum file size: 4.19MB Upload photos of asset from all angles including view of surroundings. Limit 6 photos. JPG, PNG, GIF or PDF only. 30MB size limit per photo. Comments Confirmation of Terms * REQUIRED I have read and agreed to the following: LaserQuik provides estimates for jobs. However, additional items may be added by LaserQuik as required during job. State/city/county fees accrued in delivery or pickup will be charged to the customer. IMPORTANT: Trips cancelled due to unsafe weather (i.e. high winds, ice, snow) in route will be subject to a dry run charge. LaserQuik requires the asset to be in roadworthy condition for length of trip performed. LaserQuik requires all jobs to have reasonable route access for the width, length, height & weight of the unit. Unit’s placement must have reasonable access on all sides and site conditions must support LaserQuik equipment at the time job has been requested. Towing bills and additional labor due to stuck trucks will be billed to LaserQuik customers. PAYMENT: Cash on Pickup unless paid by credit card in advance. If you are human, leave this field blank.