Order Type: Prefered Delivery Date: Representative Name: Representative Email: Representative Contact Number: Representative Account Number: Site Name: Site Address: , Site Contact Name: Site Phone Number: Site Mobile Number: Site Email Address: I acknowledge both landline and mobile phone numbers are required. If the driver cannot communicate with the store contacts on the numbers provided 1 hour to delivery, the delivery will be aborted and charges will apply.
Double Door Fridge: Large Single Door Fridge: Small Single Door Fridge: Something else: Details: Equipment Preference:
Open Time: Close TIme: Enterence Size: H x WSteps: Lift: Loading Zone: Site Photo:
It is agreed that Worldwide Refrigeration Rentals Pty Ltd (Company) will hire to the Hirer the following refrigeration equipment subject to the following terms and conditions:
I have seen the premises and believe that the information provided on this form to be true and correct and that the fridge I have selected will be suitable for the stated premises. I acknowledge that there will be additional freight charges for a nonstandard delivery.
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Document Name: Quality Foods Refrigeration Request
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