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SERVICE REQUEST FORM
Date
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E-mail
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Pickup Location
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Address
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City
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Zip Code
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Contact Name
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Phone Number
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Pick-Up Time
Between
Fixed Time
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or Fixed Time.
From
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Format: 09:00 AM
To
To Time required.
Format: 11:15 PM
Frequency
Monday
Tuesday
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Sunday
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Delivery Information
Address
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City
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Zip Code
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Contact Name
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Phone Number
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Return Time
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Special Instructions
Billing Information
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Copy Delivery Information
Billing To
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Account #
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Address
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City
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Zip Code
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Contact Name
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Phone Number
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Authorized By
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Fax
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Declared value and Limit of Liability
We will not be responsible for any claim exceeding $50.00 per shipment, whether the result of loss, damage delay or non-delivery, unless you request a higher declared value limit at the time you place your order, or at the time of pickup. Furthermore, you must pay $.50 per $100 of additional value you declare and document your actual loss. Your right to recover from us for any loss includes intrinsic value of the package, loss of sales, interest, profit, attorney fees, costs or other forms of damage, whether direct or incidental and is limited to the greater of the $50 or the Declared Value but cannot exceed actual documented loss. Streetwise Special Delivery, Inc., upon your request and with some limitations, refund all transportation charges paid.
Any damage must be evidenced by the consignee noting such at time of delivery, by making the appropriate notations on the Bill of Lading. All claims must be filled within ninety (90) days of the date of delivery.
By selecting this box you agree to our terms and limits of liability described above.
Please agree to our terms and limits of liability.
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Hours: 24 hours a day/7 days a week
Telephone:408.846.8158 | 800.635.7531
Serving Northern California
info@streetwisesd.com
