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Delivery Restriction Form
Sales Order Information:
Please select the location you work at:
*
Airport
Calle Ocho
Plantation
Palmetto
Hialeah
Pines
Kendall
Wellington
Coconut Creek
West Palm Beach
Ft. Myers
Cutler Bay
Naples
St. Petersburg
Wesley Chapel
Online Store
Sales Order Number:
*
Customer Code:
*
Delivery Date:
*
+
Delivery Zone
*
Restriction Submitted on:
*
Delivery Address Information:
Community/Building Name:
*
Delivery Address:
*
Apartment No:
City:
*
State:
*
Zip Code:
*
Restriction Information:
Please Select Type of Restriction
*
🛈
Restricted Delivery Hours
Elevator Reservation
Proof of Insurance Required
TIM
Other Restriction or Comments (not listed above)
Other Restriction or Comments (not listed above)
Restricted Delivery Time
*
Elevator Reservation Hours:
*
TIM - Specific Time Requested:
*
Certificate Holder Name:
*
🛈
Email Adddress:
Contact Fax Number:
Contact Information:
Contact Name:
*
Contact Phone Number:
*
Sales Associate Name:
*
Delivery Restriction
Delivery Restriction Form - El Dorado Furniture Corp.