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Home My WebLink AboutCORRESPONDENCE - GENERAL CORRESPONDENCE - MOVING EXPENSESESTIMATE/INTERSTATE 330 SOUTH MANNHEIM ROAD ® B/L REF. NO. ORDER FOR HILLSIDE, ILLINOIS 60162 ammm REG. OFFICE SERVICE PHONE: 708-547-2000 BAPO No. MC-52793 DOT# 76029 VAN LINES, LLC � e 6 SHIP R PHONE CONSIGNEE /f PHONE a C 5Lz ADDRESSAPT. FLOOR CITY � COUNTY STATE ZIP LET COD ❑ CPN ❑ DOD ❑ GOV "Your Rights & Responsibilities When You Move" Brochure Shipper's Initial: RATING WT A05-00 CU. FT. I5-CA MILES 1/97 TARIFF r2 PROVISO BASE EXCESS TOTAL CHARGE RATE/CWf LINEHAUL MIN. SHIPMENT W .. , MIN. SHIPMENT CHARGE ❑ EXCLUSIVE USE OF A ❑ SPACE RESERVATION OF ❑ BULKY ARTICLE (describe) CU. FT VEHICLE CU. FT. PACKING DATE AGREED PICK-UP DATE AGREED DELIVERY DATE REQUESTED OR PERIOD OF TIME OR PERIOD OF TIME QUALIFIES FOR GUARANTEED PICKUP AND DELIVERY ❑ YES ❑ NO Per Tariff Guaranteed per diem is up to $125.00 a day or 100% actual lodging costs, plus 50% food expenses supported by receipts, whichever is less. CUSTOMER'S DECLARATION of VALUE THIS IS A TARIFF LEVEL OF CARRIER LIABILITY - IT IS NOT INSURANCE Unless you select the Ahernative Level of Liability shown below your shipment will be transported under your mover's FOR ALL ITS WORTH level of liability. If any article is lost, destroyed or damaged while in your mover's custody, your mover will, at its option, either 1) repair the article to the extent necessary to restore it to the same condition as when it was received by your mover, or pay you for the cost of such repairs; or 2) replace the article of like kind and quality, or pay you for the cost of such a replacement. An additional charge applies for this level of liability; to avoid this additional charge, you must select the Alternative Level of Liability shown below. Under the FOR ALL ITS WORTH level of liability your shipment will be transported based on a value of not less than as 000 or $5 00 per pound multiplied by the actual weight of the shipment whichever is greater. If you wish to declare a higher value for your shipment, you must that amountbelow: , �indicate All L7j � •v The value of my shipment Is: f� • My You must also select one of the following deductible amounts under the FOR ALL ITS WORTH level of liability that will apply for your shipment (if you do not make a selection, the "No Deductible" level will apply): _/" No Deductible ( ) $250 Deductible ( $500 Deductible ( (initial) (initial) (initial) ALTERNATIVE LEVEL OF LIABILITY - Released Value of 60 Cents Per Pound Per Article (Waiver of FOR ALL IT'S WORTH level of liability) If any article is lost, destroyed or damaged while in your mover's custody, your mover's liability is limited to the actual weight of the lost, destroyed or damaged article multiplied by 60 cents per pound per article. This is the basic liability level and is provided at no charge. It is considerably less than the average value of household goods. If you do not select this Alternative Level of Liability, your shipment will be transported at the FOR ALL ITS WORTH level of liability and you will be assessed the applicable valuation charge. To waive the For All It's Worth level of liability and to select the Alternative Level of Liability, you must write on the line below, the words "60 cents per pound". The value of my shipment is: Your signature is REQUIRED here: I acknowledge that for my shipment I have 1) either waived the For All It's Worth level of liability OR declared a value under the For All It's Worth level of liability and selected a deductible amount, if appropriate and 2) received and read a copy of the "Your Rights and Responsibilities When You Move" brochure explaining these provisions. (Customer's Signature) (Date) EXTRAORDINARY (UNUSUAL) VALUE ARTICLE DECLARATION: I acknowledge that I have prepared and retained a copy of the "Inventory of Items Valued in Excess of $1.00 Per Pound Per Article" that are included in my shipment and that I have given a copy of this Inventory to the mover's representative. I also acknowledge that the mover's liability for loss of or damage to any article valued in excess of $1.00 per pound will be limited to $1.00 per pound for each pound of such lost or damaged article (based on actual article weight), not to exceed the declared value of the entire shipment, unless I have specifically identified such articles for which a claim for loss or damage is made or, the attached inventory. (Customers Signature) (Date) CHARGES PAYABLE IN CASH, CERTIFIED CHECK, TRAVELERS CHECK, OR BANK CHECK (PER TARIFF), PAYABLE TO BEKINS VAN LINES, LLC, OR APPROVED CREDIT CARD. If credit extended on basis of shipper's employer's or other's promise to pay part or all charges, shipper acknowledges that he remains primarily liable for payment. ❑ ORIGIN ❑ DESTINATION PREPAYMENT REMITTED TO CREDIT: INVOICE TO ADDRESS CITY CHARGES AUTHORIZED BY 025C 5/06 CORP. # _ STATE ZIP P.O. ADDRESS_ ` + APT. PUOOR 7y"(( ! CITY COURT? STATE ZIP SHIPPER'S CONTACT: ❑ ENROUTE ❑ AT DESTINATION SHIPPER REQUESTS NOTIFICATION OF ACTUAL CHARGES: ❑ YES ❑ NO NAME PHONE ADDRESS CITY STATE/ZIP DESTINATION/DELIVERING AGENT NAME PHONE CODE ADDRESS - - CITY STATE/ZIP THE PRICE SHOWN BELOW IS BASED ON ACTUAL WEIGHT AND SERVICES PERFORMED. TRANSPORTATION CHARGE �,[ p ORIGIN SERVICES r- Li• ' °n DESTINATION SERVICES VALUATION CHARGE g1fg. w �j C><7 INSURANCE SURCHARGE cSrrffg8, FUEL SURCHARGE tJK�. tl`O THE CHARGES CONTAINED HEREIN ARE JUST AN ESTIMATE. THIS SHIPMENT WILL BE BILLED ACCORDING TO SCALE • `- WEIGHT AND IN ACCORDANCE WITH PREVAILING RATES CONTAINED IN CARRIER'S PUBLISHED TARIFFS. THE ESTIMATED AMOUNT OF THIS PRICE IS SHOWN AT RIGHT, BUT YOU WILL BE REQUIRED TO PAY CHARGES ACCORDING TO ACTUAL WEIGHT. HOWEVER, THE MAXIMUM AMOUNT REQUIRED TO BE PAID ON DELIVERY SHALL NOT BE MORE THAN THE CHARGES MULTIPLIED BY 110%, PLUS CHARGES FOR ANY ADDITIONAL SERVICES THAT YOU REQUESTED AFTER THE CONTRACT FOR SERVICE WAS EXECUTED THAT WERE NOT INCLUDED IN THE ESTIMATE, AND ANY CHARGES THAT APPLY TO IMPRACTICAL OPERATIONS, AS DEFINED BY THE APPLICABLE TARIFF, EXCEPT THAT THE CHARGES COLLECTED AT DELIVERY FOR SUCH OPERATIONS SHALL NOT EXCEED 15% OF ALL OTHER CHARGES DUE AT DELIVERY. THE CHARGES NOT COLLECTED AT DELIVERY, WILL BE BILLED TO THE SHIPPER AND SHALL BE DUE WITHIN THIRTY (30) DAYS FOLLOWING PRESENTATION OF THE FREIGHT BILL. To be effective, this document is signed by an authorized BEKINS representative, and the shipper. REMARKS: P % , & pl Ac .to 1+411144 d-Illi Q rZ4 r x+k" Ph&k se rvir c rutl �►Ictyk__�_.d�/ �ss�s�..j� ly 4-Ae �.n� ,1�, q� tw&, u i HAVE READ BOTH SIDES OF THIS DOCUMENT, AGREE TO ITS PROVISIONS AND ACKNOWLEDGE RECEIPT OF A COPY. X DATE CUSTOMER (SHIPPER OR AGENT) By lOwc ` C�33 lZ1Q�6j CARRIER'S REPRESENTATIVE CODE DATE PRIVATE RELO. GIVE TO CUSTOMER-CORP. MAIL TO BOOKING AGENT IIIIYIIIIIIIIIIII VALUATION OPTIONS AVAILABLE VALUATION PROTECTION IS AVAILABLE ONLY THROUGH THE CARRIER'S TARIFF - IT IS NOT INSURANCE. Available valuation protection options are explained in more detail below. The shipment will move subject to the rules and conditions of the carrier's tariff. Valuation option selertion on the Estimate I Order for Service indicates o�rx Wit. The actual level of carrier liability should be declared in writing by you the Shipper, in the Customers Declaration of Value section on the BM of Lading. 1- FuN Val Protection Carrier's Full Value Protection level of liability is the most comprehensive plan available for protection of your shipment. There is a charge for Full Value Protection; you must specfcaNy request FUN Value Protection and the appropriate deductible level wi wrung in the Customer's Declaration of Value section on the Bill of Lading. The minimum protection you can buy under Full Value Protection is equal to $6.00 times the net weight of the shipment or $5,000 of total valuation, whichever is greater (For example, on a 10,000 lb. shipment, the minimum valuation would be 10,000 lbs. x $6.00 = $60,000). Carrier will be liable to you for any repairs or cost of repairs to items damaged in transit to the extent necessary to restore them to the same condition they appeared when we received them. In the event carrier determines the items to be unrepairable, then the carrier has the option to replace the item with like -kind and quality or cash settle at replacement costs, subject to you selecting one of the following Full Value Protection deductible amounts that will apply for your shipment: $0 Deducttile Full! Value Protection. Under this selection you are covered for the cost of repairs (as determined by carrier) or the replacement cost for items of like -kind and quality for unrepairable items or items documented in writing at delivery as missing from the shipment. You are covered from the first dollar of loss to a maximum settlement of the total released value. $250 Deductible Fri Value Protection. Under this selection, the shipper assumes responsibility for the first $250 of any damage claim. You are still covered for the first dollar of loss due to documented missing items. Except for the $250 deductible on damage claims, you will have the same protection as under the $0 deductible selection. $500 Deductible RA Value Protection. Under this selection, the shipper assumes responsibility for the first $500 of any damage claim. You are still covered for the first dollar of loss due to documented missing items. Except for the $500 deductible on damage claims, you will have the same protection as under the $0 deductible selection. 2 - Released Value of 60 Germs Per Pound Per Article This very basic plan is the least comprehensive plan we offer. There is no charge for $.60 per lb. per article, but you mast waive FtA Value Protection and spedficaNy request it fim.. 60 cents per pound per arbde) in writing in the Customers Declaration of Value sect on on the Bill of Lading. Under this valuation, carrier's maximum liability for a 70 pound item lost or damaged would be $42.00 (70 lbs. x $ .60 = $42.00). Depredation is also considered by carrier when determining settlement amounts. This plan is used most frequently by corporations that have blanket coverage for their employees. Inventory of I6erms Valued in Excess of $1W Per Pound Per Article - High Vallue Inventory Form Your mover's liability for loss or damage to articles that have an extraordinary value is limited, unless you specifically list these articles on the Inventory of Items Valued in Excess of $100 Per Pound Per Article (High Value Inventory) form. An article of extraordinary value is any item which has a value in excess of $100 per pound. Your signature on the front of this form acknowledges that you have received the High Value Inventory form. It is your responsibility to study the provisions of the High Value Inventory form carefully and make the necessary declaration, The High Value Inventory form is required on every move unless a national account contract specifically waives its use. For shipments released at .60 Cents Per Pound Per Article, the customer should write "Not Applicable" on the form as the provision does not apply to shipments released at .60 Cents Per Pound Per Article. MAYFLOWER TRANSIT, LLC ESTIMATE / One Mayflower Drive ORDER FOR SERVICE ESTIMATE NUMBER Fenton, MO, 63026 (pose refer to this number in any correspond) PHONE 636-305-5000 ADDITIONAL SERVICES PRICE LIST Shipper: Jeff Scheick I U.S. DOT No. 125563 IMPORTANT NOTICE TO SHIPPER: Below is a list of enroute and/or destination services and corresponding rates/charges, which you or your designated representative may request ar that may be necessary to deliver your household goods shipment. We have reviewed these services with you and to the best of your knowledge no such services are required at this time. These potential services and their cost are based upon the tariff issued in accordance with the regulations of the Surface Transportation Board of the Department of Transportation. The rates/charges for these enroute and/or destination services (should you request them or if they are necessary to deliver your shipment) will be based on actual weight and/or per occurrence and are in addition to all other charges on the estimate you received at origin. The carrier must deliver and relinquish possession of property transported by it upon payment of not more than 110% of the non -binding estimate (Option "A") amount paid in cash, certified check, traveler's check, bank check (one drawn by a bank on itself and signed by an officer of the bank), and/or specific pre -authorized credit card(s). However, if only partial delivery of the shipment is made, the carrier may not charge more than a prorated percentage of up to 110 percent of the non -binding estimate. The prorated amount must be based on the percentage of the weight of that portion of household goods delivered relative to the total weight of the shipment. Payment in full of any remaining charges shall be due within thirty (30) days following the presentation of the freight bill. SERVICE DESCRIPTION [ESTIMATED WEIGHT] : 13283 SERVICE BASIS RATE / CHARGE Full Unpacking Per CWT $ 608.36 Auxilliary Service / Shuttle $ 923.20 Extra Stops Per Stop $ 39.82 Waiting Time Per Man Per Hour $ 24.49 Extra Labor Per Man Per Hour $ 24.49 Overtime Unloading Per CWT $ 504.75 1st Day Storage -In -Transit Per CWT $ 958.07 Each Additional Day Storage -In -Transit Per CWT Per Day $ 37.88 Delivery Out of Storage -In -Transit $ 2919.16 1.5 - CP Per Carton $ 1.89 3.0 - CP Per Carton $ 2.86 4.5 - CP Per Carton $ 3.48 Book Carton - CP Per Carton $ 1.89 Dish Pack - CP Per Carton $ 7.90 Mirror Crt. - CP Per Carton $ 6.88 Qn/Kn Matt. - CP Per Carton $ 5.48 Single Matt. - CP Per Carton $ 3.32 Wardrobe - CP Per Carton $ 3.88 MAYFLOWER TRANSIT, LLC ESTIMATE % One Mayflower Drive ORDER FOR SERVICE ESTIMATE NUMER Fenton, MO, 63026 (please refer to this rRxnber in any correspondence) PHONE 636-305-5000 ADDITIONAL SERVICES PRICE LIST Shipper: Jeff Scheick U.S. LOT No. 125563 The Additional Services Price List has been provided to inform you, our customer, of the costs of potential services that may have to be performed enroute or at destination to complete your move. At this time, you may not think these services will be required, however, we would like you to understand the nature of and the reasoning behind the charges, should any of these services become necessary. EXPLANATION OF TERMS SHUTTLE SERVICE - In cases where it is impossible for the van operator to deliver your shipment directly from the over -the -road vehide (usually a long tractor -trailer), either because of the physical terrain characteristics (such as tight turns, overhanging branches, etc.) or safety considerations, you may request, or the van operator may require, shuttle service. A shuttle service includes placing your household goods on a smaller vehicle and transporting them between the over -the -road vehicle and your residence. While the charge shown on the Additional Service Price List has been based on the estimated weight of your shipment, the actual charge will be based on the actual weight of the shipment and the location where the service is provided. EXTRA STOP - The transportation charge includes loading from a single address and delivery to a single address. If you would like us to deliver a portion of your shipment to another location other than the destination, there is a flat charge for each extra delivery. WAITING TIME - If the van operator arrives at destination, and you are unable, for whatever reason, to accept delivery, the van operator will wait for up to two hours at no charge. After two hours, Waiting Time charges will apply for the truck and Extra Labor charges will apply for the van operator and any helpers that have been hired. These charges apply in conjunction with each other and are charged on a per vehicle, per man, per hour basis (quarter hour increments -- 15 minute minimum). EXTRA LABOR - If the carrier is requested to provide a service and the tariff does not indicate a charge for the service, Extra Labor charges apply. Examples of situations where extra labor applies, but are not limited to, Waiting Time (as indicated above), unpacking "packed by owner" cartons, placing items in attics / crawl spaces, and removing / replacing doors and railings. Extra Labor applies on a per man, per hour basis (quarter hour increments -- 15 minute minimum). UNPACIUNG - Unpacking includes the removal of items from carrier packed cartons, placing those items on the nearest flat surface, and the disposal of any packing debris. It does not include placing items into cabinets or closets. Most customers do not want the mover to do any unpacking other than unpacking their mattresses and box springs so the van operator can set up their beds. If additional unpacking is desired, either as a full or partial unpack, the cost is shown. OVERTIME UNLOADING - If you demand that the van operator only unload after 5:00 PM (Monday through Friday) or anytime on a weekend or holiday, the van operator is entitled to charge for Overtime Unloading. If the delivery is performed after 5:00 PM (Monday through Friday) or anytime on a weekend or holiday at the van operator's convenience, no additional charge applies. Overtime Unloading is applied on a per hundredweight basis, based on the actual weight of the shipment. STORE - If you cannot accept delivery at destination and your shipment must be placed into an agent's warehouse for storage -in -transit, the following charges will be incurred: • FIRST DAY STORAGE -IN -TRANSIT -This charge is for the preparation of the storage vaults, receiving the shipment into storage, and preparation of storage documentation. This charge is applied on a per hundredweight basis, based on the actual weight of the shipment. • EACH ADDITIONAL DAY STORAGE -IN -TRANSIT -The charge is for each additional day after the first day. The charge is applied on a per hundredweight basis per day, based on the actual weight of the shipment. The Storage -in -Transit period cannot exceed 180 days, after which time, the rules and rates of the warehouse will apply. ' DELIVERY OUr OF STORAGE-IN-TRIWSIr (DRAYAGE) -This charge is for delivering your belongings from the storage warehouse to your residence. This charge is based on the actual weight of the shipment and the location where the service is provided. ' EXTENDED VALUATION -If you declared Full Value Protection on your Bill of Lading, this charge is equal to 10% of the initial valuation charge and it will be applied every 15 days, or increment thereof, that your shipment remains in Storage -in -Transit. Page is too large to OCR. Page is too large to OCR. Customer: Scheick, Jeff Cummings Moving Systems, LLC Mayflower Transit, LLC 5434 River Rd. N. # 133 One Mayflower Drive Agent Keizer, OR 97303 Van Line Fenton, MO 63026 503-399-7300 636-305-5000 Ron U.S. DOT No. 125563 Table Of Measurements Origin Information Destination Information Service Information Shwer Scheick, Jeff Consignee Scheick, Jeff Estimate [late 12/17/07 Address 4595 Colony Ct SE Address City, St, zip Salem, OR 97302 City, St Zip Fort Collins, CO 80525 Pads Lute 1/17/08 to 1/17/08 phone(H) 503-315-4917 Phone(H) Load Date 1/17/08 to 1/17/08 phone (W) Phone (W) Deiver Date 1/17/08 to 1/17/08 Email cjscheick@msn.com Room: Attic Item Cube SW Not Item Cube Ship Not Item Cube S h Not 1.5-CP 1.5 2 0 1.5-PBO 1.5 2 0 3.0-PBO 3 6 0 3.0-CP 3 5 0 Room: Bedroom 2 Item Cube SW Not Bed, Single 40 1 0 Dresser, Single 30 1 0 Book Carton - CP 7 2 0 4.5-CP 4.5 3 0 Bed, Headboard 10 1 0 Room: Bedroom 3 Item Cube Shy Not Bed, Metal Frame 3 1 0 Dresser, Single 30 1 0 3.0-CP 3 4 0 Wardrobe - CP 10 1 0 Room: Dining Room Item Cube SW Not Bookshelf, Small 5 1 0 Table, Childs 5 1 0 1.5-CP 1.5 6 0 Single Matt. - CP 0 2 0 Bed, Footboard 5 1 0 Item Cube Ship Not Bed, Single 40 1 0 Toys 10 1 0 4.5-CP 4.5 4 0 Single Matt. - CP 0 2 0 Total Number of Pieces to be Shipped: 15 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 273 Item Chair, Occasional Toys 3.0 - CP Bed, Metal Frame Cube St�R Not 15 1 0 10 1 0 3 2 0 3 1 0 Total Number of Pieces to be Shipped: 24 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 1158 Item Bookshelf, Small Book Carton - CP Mirror Crt. - CP Cube ship Not 5 1 0 7 2 0 3 1 0 Total Number of Pieces to be Shipped: 19 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 1015 Item Item Cube SW Not Item Cube SSA Not Sideboard 25 1 0 Chair, Dining 5 6 0 Table, Dining 30 1 0 3.0 - CP 3 1 0 Dish Pack - CP 10 5 0 Cube Ship Not Buffet 30 1 0 Grandfather Clock 20 1 O 1.5 - CP 1.5 2 0 0 Total Number of Pieces to be Shipped: 18 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 1337 Room: Family Room Item Cube Ship Not Item Cube SW Not Item Cube SW Not Cabinet 20 1 0 Chair, Child's 3 1 0 Chair, Occasional 15 1 0 Sofa, Loveseat 30 1 0 Sofa, 3 Cushion 40 1 0 Table, Coffee / End 5 3 0 Dish Pack - CP 10 1 0 Plasma TV 50 1 0 1.5 - CP 1.5 5 0 3.0 - CP 3 4 0 Mirror Crt. - CP 3 1 0 Total Number of Pieces to be Shipped: 20 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 1438 Room: Garage Item Cube SW Not Item Cube SW Not Item Cube Ship Nol Bicycle 5 3 0 Chair, Metal 1 3 O Cooler 3 4 0 Garden Hose 2 2 0 Garden Tools 2 2 0 Golf Clubs 5 2 0 Ladder, 8' Metal 4 1 0 Mower, Power 15 1 0 Refrig., 7 to 10 cf. 45 1 0 Spreader 2 1 0 Suitcase 5 3 0 Wagon 5 1 0 Work Bench 20 1 1 Weights 2 11 0 1.5 - CP 1.5 3 0 3.0 - CP 3 3 0 4.5 - CP 4.5 2 0 Weight Rack 15 1 0 Cupboard 15 0 3 Trash Can 2 0 1 Total Number of Pieces to be Shipped: 45 Total Number of Pieces NOT to be Shipped: 5 Estimated Room Weight: 1494 Room: Hallway Item Cube Shy' Not Item Cube SF�' Not Item Cube SW Not Vacuum Cleaner 5 1 0 3.0 - CP 3 2 0 Mirror Crt. - CP 3 1 0 Wardrobe - CP 10 1 0 Easel 3 1 0 Book Carton - CP 7 5 0 Total Number of Pieces to be Shipped: 11 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 434 Room: Kitchen Item Cube Ship Not Item Cube SW Not Item Cube SHp NoI Chair, Kitchenette 5 4 0 Chair, High 5 1 0 Refrig 11 cf. or > 60 1 0 Table, Dining 30 1 0 Book Carton - CP 7 4 O 1.5 - CP 1.5 4 0 3.0 - CP 3 6 0 4.5 - CP 4.5 2 0 Dish Pack - CP 10 7 0 Microwave Oven 5 0 1 Total Number of Pieces to be Shipped: 30 Total Number of Pieces NOT to be Shipped: 1 Estimated Room Weight: 1722 Room: Living Roam Item Cube Shp Not Item Cube Not Item Cube S jNoI Chair, Occasional 15 2 0 Sofa, Loveseat 30 1 0 Table, Coffee / End 5 3 0 3.0 - CP 3 1 0 4.5 - CP 4.5 2 0 Mirror Crt. - CP 3 3 0 Rocking Horse 4 1 0 0 Total Number of Pieces to be Shipped: 13 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 700 Room: Master Bedroom Item Cube SW Not Item Cube SW Not Item Cube SNp Not Bed, Metal Frame 3 1 0 Bed, King 70 1 0 Chair, Arm 5 1 0 Chest 12 1 0 Hamper 5 1 0 Dresser, Single 30 1 0 Dresser, Double 40 1 O Table, Night 5 2 0 1.5 - CP 1.5 2 0 3.0 - CP 3 6 O 4.5 - CP 4.5 3 0 Dish Pack - CP 10 2 0 Qn/Kn Matt. - CP 0 2 0 Mirror Crt. - CP 3 1 0 Wardrobe - CP 10 5 0 Bed, Headboard 10 1 0 Bed, Footboard 5 1 0 Total Number of Pieces to be Shipped: 32 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 2082 Room: Office Item Cube Ship Not Item Cube Shy" Plot Item Cube SW Not Computer/Printer 4 1 0 Chair, Arm 5 1 0 Desk, Office 30 1 0 Exercise Machine 65 1 O TV, 25-27 10 1 O 3.0 - CP 3 5 0 Total Number of Pieces to be Shipped: 10 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 903 Room: Porch/Outdoor Item Cube SNp Not Item Cube Shp Not Item Cube SW Not BBQ Grill, Large 10 1 0 3.0 - CP 3 1 0 Plant Hook 3 3 0 Total Number of Pieces to be Shipped: 5 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 154 Room: Utility Item Cube Shp Not Item Cube Shiip Not Item Cube SIhiip Not Dryer 25 1 0 Washing Machine 25 1 0 1.5 - CP 1.5 3 O 3.0-CP 3 3 0 4.5-CP 4.5 4 0 Total Number of Pieces to be Shipped: 12 Total Number of Pieces NOT to be Shipped: 0 Estimated Room Weight: 570 Moue Summary Total Cubic Feet: 1897.5 Total Estimated Weight: 13282 Number Pieces to Be Shipped: 254 Number Pieces NOT Shipping: 6 CP Summary Carton Type Qty Carrier Pads Qty Carrier Unpack f .5 - CP 27 0 3.0-CP 43 0 4.5-CP 20 0 Book Carton - CP 13 0 Dish Pads - CP 15 0 Mirror crt. - CP 7 0 Qn/kn Matt. - CP 2 2 Single Mate - CP 4 4 Wardrobe - CP PBO Summary Carton Type Quantity MIM— 41 3.0 - PBO Customer Signature: date:12/17/07 Salesperson Signatur date:12/17/07 8 MAYFLOWERTRaNSIT, LLC ESTIMATE / ESTIMATE NUMBER One Mayflower Drive ORDER FOR SERVICE (please refer to this numb in any correspondence) Fenton, MO, 63026 PHONE 636-305-5000 U.S. DDT No. 12S563 CONSIGNOR CONSIGNEE Stripper: Scheidt, Jeff Shipper: Scheidt, 3eff Company (Associated With): Street Address: Street Address: 4595 Colony Ct SE City, State, Zip: Fort Collins, CO 80525 City, State, Zip: Salem, OR 97302 Destination Phone: Origin Phone. 503-315-4917 Contact: Phone: Contact: Phone: FORM OF PAYMENT (per tariff): BILL TO NOTIFY (_) C.O.D (_) PPD. (_) GOV. (_) NAT. ACCT. #: NOTIFY IN CASE OF: (_) Delay (_) Charges Bill To: Name: Street Address: Street Address: City, State, Zip: City, State, Zip: Attn: P.D. No.: Phone: E-Mad: AGREED PICK UP DATES AGREED DELIVERY DATES Early - 1/17/08 Late - 1/17/08 Preferred - Early - 1/17/08 Late - 1/17/08 Preferred - PACK DATE BIDING DATE CONTRACT NO TARIFF SECTION EXCEPTION MILES BOUND WT. ACTUAL WT. 1/17/08 12/17/07 MT01 3H 1179 13283 13283 (_) GUARANTEED SERVICE DATE - DAILY ALLOWANCE (if applicable, per tariff): J125.00 Per Da v **VOLUME / WEIGHT CONVERSION = 7 LBS, PER CUBIC FOOT** SHIPPER REQUESTS TO VIEW WEIGHINGS ( YES (_)NO TOTAL PRICE DUE AT TIME OF DELIVERY: $15065.76 I TOTAL BOUND CHARGES: $8984.92 (Unless an Addendum or a New Est ffkft / order for Service is Exearted) TOTAL NON -BOUND CHARGES: $6080.84 TERMS 1. All terms written, and printed, stamped, or typed on all pages (front or back) of this form, are agreed to by both parties. 2. If the carrier extends credit by agreeing to bill an employer or other party, and in the event that any or all of the charges are not paid, the owner of the goods and/or beneficiary of the services acknowledges he remains primarily liable for payment. 3. COLLECT SHIPMENTS: Unless other payment arrangements are made with the carrier in writing signed by the carrier, this shipment is a collect shipment. Forms of payment honored at delivery on Called shipments (as provided in carriers tarih) in U.S. ftmds are Cash, Certified Check, Travelers Check, Bank Check (drawn by a bank on iself), and/or specific PRE -AUTHORIZED Credit Cmd(s). All drafts must be payable to the carrier. All charges subject to audit, and if necessary will be corrected by refund or additional billing. 4. This shipment is a Binding (Option "C - Comparison) Estimate between AERM and the Shipper. The total binding price includes only the services and quantities listed as included in this binding amount, Additional cost may result if items are added to the shipment or are necessary to accomplish delivery, 5. If total charges for services exceed the amount of the total binding price, the carrier must relinquish possession of your shipment upon payment of 100% of the total binding price amount. You are obligated to pay the balance of the total charges upon receipt of carrier's freight bill. The charges for services or quantities that are in addition to those collected at delivery must be billed to shipper within 15 days of the date of delivery (or if the carrier lacks sufficient information to compute the charges they must be billed to the shipper within 15 days of the date when sufficient information becomes available) and shall be due within 30 days following presentation of the freight bill. 6. The Shipper agrees that title to all packing materials and other property sold to Shipper passes to Shipper rp for to the transportation of such property for the Shipper by carrier. 7. In the event storage -in -transit services are riot estimated but are provided, the cost of these services will be in addition to the amount stated. Such services and applicable charges will be based upon the actual weight of the goods stored in transit for actual days in storage. An additional valuation charge will apply on shipments that are provided Full Value Protection Level of Service. 8. The Shipper agrees that the carrier shall transport the goods and effects tendered by the Shipper subject to the preceding. Ovwo4e (CcL(- carrtf.'r-) � q q `9 To yb+ct �� \ ��.�l 00 s jD-7 a,a®� t� %55a, -Tf%Lu�_— � VALUATION CUSTOMER DECLARATION of VALUE THIS IS A TARIFF LEVEL OF CARRIER LIABIILITY - IT IS NOT INSURANCE ALTERNATIVE LEVEL OF LLaBRIfY- Rem VahUe of 60 Cents Per Pound PerArt;de (Waiver of FULL VALUE) Unless you select the,aGerrkitive Level of Liability shown in the cohmn to the right, your shipment will be transported under your mover's FULL VALUE PROTECTION level of If any article is lost, destroyed or damaged while in your mover's custody, your mover's liability. If any article is lost, destroyed or damaged while in your mover's custody, your liability is limited to the actual weight of the lost, destroyed or damaged article multiplied mover will, at its option, either 1) repair the article to the extent necessary to restore it by 60 cents.per pound per article. This is the basic liability level and is provided at no to the same condition as when it was received by your mover, or pay you for the cost of charge. It is considerably less than the average value of household goods. If you do not such repairs; or 2) replace the article with an article of like kind and quality, or pay you for select this Alternative Level of Liability, your shipment will be transported at the Full Value the cost of such a replacement. An additional charge applies for this level of liability; to level of liability and you will be assessed the applicable valuation charge. avoid this additional charge, you must select the Alternative Level of Liability shown in To waive the FULL VALUE PROTECTION Level of Liability and to select the W6ematire the column to the right. Level of Liability, you must write, on the line below, the words "6o cents per pound:' Under the FULL VALUE PROTECTION level of liability your shipment will be transported The value of my shipment is: based on a value of not less than $5000 or $6.00 per pound muttplied by the actual Yoe silginatime is REQUWM here: I acknowledge that for my shipment I have efttw weight of the shipment, whichever is greater, If you wish to declare a higher value for waived the FULL VALUE PROTECTION Level of liability OR declared a value under the FULL your shipment, you must inlik to that amount below: VALUE PROTECTION Level of viability and selediBd a deductible amount if appropriate. The value of my shonent is: You must also select one of the following deductible amourim under the FULL VALUE PROTECTION level of liability that will apply for your shipment ( if you do not make a selection, the "No Deductible" level will apply): 12117/07 No Deductible (initial -_) $250 Deductible (initial -_) $500 Deductible (initial -_) Customer's Signature Date Shipper hereby makes, constitutes and appoints (Name) (Address) (Phone) as true and lawful agent for shipper to act in shipper's name, place and stead, to give carrier instructions, perform all acts and to execute all documents pertaining to the transportation and services ordered. Estimate Acknowledgement Order For Service Acknowledgement Your signature is required here, acknowledging your stated declaration of value (noted above) and receipt of the following: 1) Estimate; 2) Your Rights & Responsibilities When You Move brochure; 3) Ready to Move brochure; 4) Inventory of Items Valued in Excess of You should sign below only if you wish MAYFLOWER TRANSIT, LLC to perform all of the $100 Per Pound Per Article (High Value Inventory) form. services indicated above. By signing, shipper also acknowledges receipt of the Order for Service. 12 17 07 2 15 08 Shipper's Signature (Date Received) (Valid Thru Date) 12 17 07 Shipper's Signature (Date Received) 12 17 07 M991 rrier's Representative (Date) Agent Code L_J MAYFLOWER TRANSIT, LLC One Mayflower Drive ESTIMATE / ESTIMATE NUMBER Fenton, MO, 63026 ORDER FOR SERVICE (please refer to This number in any correspondence) PHONE 636-305-5000 U.S. DOT No. 125563 Shipper: Jeff Scheick AGENT AGENT NBR NAME ADDRESS CITY, STATE, ZIP PHONE BOOKER M991 Cummings Moving Systems, LLC 5434 River Rd. N. #133 Keizer, OR 97303 503-399-7300 ORIGIN M991 Cummings Moving Systems, LLC 5434 River Rd. N. #133 Keizer, OR 97303 503-399-7300 DESTINATION CUBIC FEET MINIMUM WEIGHT WEIGHTADDITIVE AUTO WEIGHT TOTAL WEIGHT 1897.5 2100 0 0 13283 TOTAL TRANSPORTATION $ 6056.49 VALUATION LEVEL SEIECIED: T FVP - $0 - $100000.00 VALUATION COST: $ 798.00 CONTAINERS ONLY CONTAINERS AND PACKING UNPACKING CONTAINER DESCRIPTION QUANTITY PER EACH TOTAL QUANTITY PER EACH TOTAL QUANTITY PER EACH TOTAL 1.5 - CP 0 0.00 0.00 27 7.56 204.12 0 0.00 0.00 3.0 - CP 0 0.00 0.00 43 11.44 491.92 0 0.00 0.00 4.5 - CP 0 0.00 0.00 20 13.96 279.20 0 0.00 0.00 Book Carton - CP 0 0.00 0.00 13 7.56 98.28 0 0.00 0.00 Dish Pack - CP 0 0.00 0.00 15 31.61 474.15 0 0.00 0.00 Mirror Crt. - CP 0 0.00 0.00 7 27.50 192.50 0 0.00 0.00 Qn/Kn Matt. - CP 0 0.00 0.00 2 21.90 43.80 2 5.48 10.96 Single Matt. - CP 0 0.00 0.00 4 13.30 53.20 4 3.32 13.28 Wardrobe - CP 0 0.00 0.00 7 15.51 108.57 0 0.00 0.00 TOTAL CONTAINER ( $ 0.00 MAX PACK TOTAL PACKING 1 $ 1945.74 1 TOTAL UNPACKING 1 $ 24.24 LBS. X $ 1 1CWT. _ $ TOTAL CONTAINERS PACKING & UNPACKING $ 1970M 3RD PARTY/ADVANCE CHARGES DESCRIPTION POINT OF SERVICE CHARGE Plasma Crate $ 890.00 Plasma Uncrate $ 215.00 ' ..MUST BE SUPPORTED BY INVOICE** ' TOTAL 3rd PARTY &ACE CHARGES (NON -BOUND) I $ 1305.00 STORAGE SIT PICKUP / STT PICKUP / ORIGIN SIT WEIGHT DEL. MILES RATE CHARGE DESTINATION SIT WEIGHT DEL. MILES RATE CHARGE 0 13283 $ 0.00 $ 0.00 15 13283 $ 2919.16 $ 2919.16 1ST DAY I DATE IN: $ 6.55 $ 0.00 1ST DAY I DATE IN: $ 7.21 $ 958.06 2ND DAY O: NO. DAYS 0 $ 0.00 $ 0.00 12ND DAY O: NO. DAYS 29 $ 37.86 $ 1098.60 WAREHOUSE HANDLING WAREHOUSE HANDLING EXTENDED VALUATION 10% $ 0.00 EXTENDED VALUATION 10% .60 R'3 TOTAL STORAGE (NON -BOUND) t TOTAL NON -BOUND: $ 6M.84 TOTAL BOUND: $ 8984.92 MAYR-OWERTRANSrr, LLC One Mayflower Drive ESTIMATE >t ESTIMATE NUMBER Fenton, MO, 63026 OPOER FOR SERVICE (please refer to ttw rKmnber in any correspondence) PHONE 636-305-5000 U.S. DOT NO. 125563 Shipper: Jeff Scheick ESTIMATE / ORDER FOR SERVICE - aNWAARY II44=0RN11ATION The rules, rates and provisions in carriers published tariff including the software portion thereof are hereby incorporated by reference. The carrier's tariff, the Estimate / Order for Service and any Addendums thereto, together with any applicable National Account Contract Agreements, and Bill of Lading and all Inventories prepared in conjunction with the Bill of Lading constitute the contractual documents governing Shippers move. In the event of any conflict between the terms of the Estimate / Order for Service and Bill of Lading, the Bill of Lading shall control. Any specific terms set forth in a National Account Contract Agreement shall supersede any inconsistent terms in the other documents. In the event Shipper requests additional services not induded in the estimate provided hereby, Shipper represents that Shipper or Shippers agent will execute any additional documents required to authorize such service. Estimate Summary Information: option "e" (Bound): This is a "bound estimate. The bound estimate price induces c�the services and quantities shown on the estimate (excluding Storage -in -Transit and 3rd party charges, if applicable). Charges are calculated using the estimated weight and estimated services, except as otherwise provided. The bound estimate price does not include charges for additional services to be performed enroute or at destination, unless specifically included in the estimate, or on Addendum thereto. If additional services are required enroute or at destination in order to properly service your shipment or are provided upon your request, the applicable tariff charges for these additional services shall be assessed and shall be in addition to the binding estimate amount. If any of these additional services are assessed on a weight basis per the tariff, actual weight will be used. Option "C' (Corn3anson): This is a "bound' estimate. Charges are calculated at the lesser of either the estimated weight and estimated services - OR -the actual weight and actual services. The bound estimate price s cm the services and quantities shown on the estimate (excluding Storage4n Transit and 3rd party charges, if applicable). The bound estimate price does not include charges for services to be performed enroute or at destination, unless specifically included in the estimate, or an Addendum thereto. If additional services are required enroute or at destination in order to properly service your shipment or are provided upon your request, the applicable tariff charges for these additional services shall be assessed and shall be in addition to the binding estimate amount. If any of these additional services are assessed on a weight basis per the tariff, actual weight will be used. The carrier will not deliver or relinquish possession of property transported by it until payment of the charges i.e., (1) 1009E of the binding estimate (Option "B" or Option "C") amount plus (2) the charges applicable for any service(s) either requested by the shipper after the contract was executed that were not included in the estimate and/or charges for impracticable operations (such as shuttle service), that do not exceed fifteen percent (15%) of the total charges due at delivery. Payment may be made by cash, certified check, traveler's check, or bank check (one drawn by a bank on itself and signed by an officer of the bank) , and/or specific pre -authorized credit card(s). The charges for services or quantities that are in addition to those collected at delivery must be billed to shipper within 15 days of the date of delivery (or f the carrier lacks sufficient information to compute the charges they must be billed to the shipper within 15 days of the date when sufficient information becomes available) and shall be due within 30 days following presentation of the freight bill. As information, "AERM" is an industry assigned abbreviation for Mayflower Transit, LLC. Carrier's liability and additional valuation purchased as extended carrier liability under published tariffs or under National Account Contract Agreements ARE NOT UMSURANCE, as that tern is used under the McCarran - Ferguson Act, 15 U.S.C. 1011-1015. The rules, regulations and carrier's provisions regarding estimates as set out in the tariffs published by the carrier and currently in effect on the date applicable, shall govern this shipment. In the event storage -in -transit services are riot estimated but are provided, the cost of these services will be in addition to the amount stated. Such services and applicable charges will be based upon the actual weight of the goods stored in transit for actual days in storage. An additional valuation charge will apply on shipments that are provided Full Value Protection level of liability. Shipper agrees that title to all packing materials and other property sold to Shipper passes to Shipper Rr Zto the transportation of such property for the Shipper by carrier. The sale price of the containers and container materials (if applicable) is indicated on front -side of Estimate / Order for Service. This sale price is included in the total packing service charge. This is an estimated charge to comply with state regulatory requirements for interstate shipments. It is not an additional charge to be paid by Shipper. The Shipper agrees that the carrier shall transport the goods and effects tendered by the Shipper subject to the preceding.