Complete Office Solutions, Inc.
Tel: 877-225-1468

Fax: 626-329-4811
www.cosinc.com

EQUIPMENT RELOCATION REQUEST 
Step 1:
BUSINESS INFORMATION
Company Name:     Requested Date for Movement:  
   
Pick Up Address:     Stairs:   Yes    No   Elevator:    Yes    No
   
This office will:  Relocate or Moving to Delivery Address   Closing Down on _______________    Other ___________
   
Contact Name:                                                Phone #:                                                    Email:
  Fax #  
Delivery Address:     Stairs:   Yes    No   Elevator:    Yes    No
   
Contact Name: Phone #: Email:  
    Fax#          
Bill To:   Pick Up Address     Delivery Address               
 
EQUIPMENT INFORMATION
Make & Model    Equipment ID#     Comments:  
             
    Finisher:    Yes      No    
         
Make & Model    Equipment ID#   Comments:  
             
    Finisher:    Yes      No    
               
Make & Model   Equipment ID# Comments:  
             
    Finisher:    Yes      No    
 
 
 
 
 
 
 
 
Complete Office Solutions, Inc. will provide in writing the estimated cost for relocating above referenced equipment. This agreement covers only the cost of relocation. Any reconnection for printing, scanning or network faxing is specifically excluded from the cost of relocation. If customer agrees to the charges as well as the terms of this request, customer must sign authorizing line below and fax back to Complete at 626-329-4811
Step 2: For Complete Office Solutions, Inc. to Fill Out
Estimated Charges:
Step 3:
Authorizing Signature: _____________________________________   Date: ______________________
Print Name: ______________________________________________
Complete Office Solutions, Inc. will not be responsible for any pre-existing damage to equipment, or any pre-existing copy quality and or functionality problems.