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New Estimate Form

BIGHAM'S LIABILITY FOR LOSS OR DAMAGE

I agree that the maximum liability of Bigham's for loss or damage is $1.00 per pound per article to a maximum of $200.00 per article or container, unless I declare a value for the goods in the space below. If I declare a value I agree to pay a fee for increased valuation coverage and agree that Bigham's maximum liability shall be limited to the value declared.

I declare the value of the shipment to be (A)$ actual cash value (B)$ new replacement value, and shall pay an additional charge for Bigham's increased liability at the rate of $ per $1,000.00. By not declaring a value I acknowledge that Bigham's liability is limited as described above.

MOVING CONDITIONS: IMPORTANT

I understand that the carrier's liability is limited by a term or condition of carriage contained in this agreement and make the declaration of value set forth above. I am the legal owner of the goods, or the authorized agent of the legal owner of hte goods to be moved or stored. I agree to the terms of this contract.

X
Customer or Agent to sign here to authorize work and terms.

 

MATERIAL SUPPLIED

PACKING SERVICE

TYPE OF
CONTAINER

EST.

MAT.
SUPP'D

UNIT
COST

AMOUNT

EST.

SUPP.
& PACK

UNIT
COST

AMOUNT

CHINA CARTON

2 CU. FT. CTN.

4 CU. FT. CTN.

5 CU. FT. CTN.

PICTURE SM.

PICTURE LG.

WARDROBES

MATTRESS S

MATTRESS D

MATTRESS Q

MATTRESS K

TELEVISIONS

TOTAL
PACKING MATERIAL

TOTAL
PACKING SERVICE

RECEIPT FOR PAYMENT

 
Deposit

Driver's
Signature

CUSTOMER'S RECEIPT FOR DELIVERY

I acknowledge receipt of goods and services. I understand that receipt of goods does not preclude future claim for loss or damage made within the time limits prescribed by the conditions of carriage.

 
Date

 
Signature

CHARGES

 

MEN

HOURS @ PER HR.

AMOUNT

FUEL SURCHARGE

VALUATION CHARGE

@

per $1,000.00

PACKING MATERIAL

PACKING SERVICE

STORAGE

CONTAINER HANDLING

STORAGE INSURANCE

@

per $1,000.00

SUB TOTAL

H.S.T.#R100508613

   

TOTAL CHARGES ➤

CHARGES PAYABLE TO DRIVER
UNLESS CREDIT ARRANGED IN ADVANCE