First Name

Last Name

Address

Address Line 2

City

State StateAlabamaAlaska (Will require Air shipping)ArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaGuam (Will require Air shipping)Hawaii (Will require Air shipping)IdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto Rico (Will require Air shipping)Rhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWest VirginiaNewfoundlandLabradorPrince Edward IslandNova ScotiaNew BrunswickQuebecOntarioManitobaSaskatchewanAlbertaBritish ColumbiaNunavutNorthwest TerritoriesYukon Territory

Zip Code

Country Country United States Canada

Email Address

Telephone Number

Product Name: (i.e. Republic Flooring Clare Valley Collection Sage Brush Waterproof SPC Max Vinyl Plank Flooring)

Product Quantity: (i.e. 3,100 SQFT or 182 Cartons)

Site Type Site Type Residential Delivery Business Delivery Non-Commercial Delivery Site End of Day Delivery

Please elaborate

Business Delivery Business Delivery Yes, we have a dock or forklift on site No dock available

No Dock Available No Dock Available Please choose a Non-Commercial Delivery Site Option

Non Commercial Delivery Site Non Commercial Delivery SiteAirport DeliveryChurch DeliveryConstruction or Utility Site DeliveryContainer Freight Station DeliveryCorrectional Facility DeliveryCountry Club DeliveryFarm DeliveryGolf Course DeliveryGovernment Site DeliveryHotel DeliveryLimited Access DeliveryMilitary Base DeliveryMine or Quarry DeliveryNursing Home DeliveryPiers or Wharves DeliveryRanch DeliverySchool DeliveryShopping or Strip Mall DeliveryStorage Facility Delivery

Delivery Accessorials Delivery Accessorials Lift-Gate Notification Prior to Arrival Inside Delivery Create an Appointment Sort & Segregate

Contact Name and Telephone Number

Date and Time ( 05/15/23 at 3:30 P.M.)

Export: Taxes & Duty Export: Taxes & Duty Tax and Duty are due upon reciept and collected by the courier. By checking this box, you are aware that these fees are not collected by The Last Inventory and they will be paid separately to the courier upon delivery.