Lab Equipment Relocation & Delivery Request Form

Equipment

Request Type*

Request for Quote
Request for Service

What are you moving?

Entire Lab
Equipment

Your Email*

Item List

List*

Manufacturer	Model	Dimensions: W-L-H (in)	Weight (lbs)	On Skid?

Is the equipment currently installed/in use?*

Yes
No

Is the equipment hardwired in or going to be hardwired in?*

Yes
No

Pick-Up Location

Company Name*

Address*

Location (Dock/Room #)

Shipping Dock?*

Yes
No

Business Hours

Delivery Location

New Construction?*

Yes
No

If New Construction, PPE Required?*

Yes
No
NA

If New Construction, is a Safety Orientation Required?*

Yes
No
NA

If New Construction, are there Elevator restrictions (i.e. booking elevator time)?*

Yes
No
NA

Delivery Location: Same as Pick-up?*

Yes
No

Company Name*

Address*

Location (Dock/Room #)

Shipping Dock?*

Yes
No

Business Hours

Moving Requirements

Stairs?*

Yes
No

Limiting Doorways?*

Yes
No

Limited Elevator Capacity?*

Yes
No

If yes to any of the above, please describe. List any hindrances that may pose a challenge to moving of equipment.*

Installation

Installation Required?*

Yes
No

All utilities are installed and meets instrument requirements?*

Yes
No

Calibration/Certification Required?*

Yes
No

Calibration Type If Known – default calibration type will be standard Gold Calibration (NIST) with certificate provided.

Packaging Material removed and recycled?*

Yes
No

Is there an older unit that needs to be disposed of? (note all equipment is decontaminated prior to disposal)*

Yes
No

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Equipment Relocation/Delivery Form