Attention: _______________________FAX
#:____________ Pages:____
AUTO EXPRESS
3020 Holliday Ave.
Apopka, Fla 32703
Phone 1-866-659-0979 or 800-237-7398
Fax: 1-843-216-6186
Pick Up Information:
Name:____________________________ City &
State:___________________
Street Address:__________________________________
Telephone Numbers: Home:____________Work:___________
EXT:_______
Cell:____________ Alternate Contact &
Telephone:_____________________
Delivery Information:
Name:_____________________________ City &
State:__________________
Street Address:___________________________________
Telephone Numbers: Home:____________ Work:___________
EXT:_______
Cell:______________ Alternate Contact &
Telephone:____________________
Vehicle Information:
Year:_________ Model:_________________
Make:_______________
Last 8 digits of VIN#_____________________
Other:__________________________________________________
Payment Information:
All payments MUST be in
the form of an ‘Official Bank Cashier’s Check’, an ‘United States Postal Money
Order’,
‘Western Union Wire
Transfer’ or ‘Cash’. NO PERSONAL OR CERTIFIED CHECKS WILL BE ACCEPTED. Deposit
must
Accompany this Shipping
Order or in the case of orders returned by FAX, payment must be received in our
office
before this order is
processed. ALL CANCELLED ORDERS FORFEIT THE TOTAL AMOUNT OF THE LISTED DEPOSIT.
TOTAL AMOUNT DUE:________________
REQUIRED DEPOSIT:______________ BALANCE DUE:______________
AVAILABILITY:
You must allow AT LEAST a 7 day period for the pick up of
the vehicle, from the first day that the vehicle becomes available OR from the
day that we have received BOTH the
shipping Order and the deposit in our office. We do not pick up vehicles on a
specific day, time,
or location. In the following space
please let us know when the vehicle is available based on the information
above:
This shipping order is provided as
a service only. Unless otherwise noted, all terms and conditions are subject to
the Uniform Bill of
Lading which is issued at the point
of pick up by the Carrier and the Carrier assumes all responsibility and
liability therein stated.
Please see the reverse side or
second page of FAX for additional Terms and Conditions. By signing and/or
returning this Shipping
Order, it is understood that all of
the information has been reviewed and accepted.
Please sign and return to
Auto Express:
**When retuning by FAX - send this
sheet only.** **Quote good for 30 days.**