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Combined Uniform Household Goods Bill or Lading and Freight Bill
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MANLY MOVING LLC
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(720)515-5754
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NameTIME RECORD
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Phone StartAM / PM
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FromCustomer Initials
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FinishAM / PM
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ToCustomer Initials
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JobHours
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OtherStopsTravelTime
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BreaksTime
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Moving rateTotalHours
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Rates and Decription of Services PerformedCharges
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Travel rateMoving
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VALUATION
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Customer is required to declare in writing the released value of the property. The agreed or declared value of the property is hereby specifically stated by the customer and confirmed by their signature heron to be NOT exceeding (.60) cents per pound per article unless specifically excepted below. The customer hereby declares valuations in excess of the above limits on the following articles:
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Packing/Supplies
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CUSTOMER – IMPORTANT – READ WHAT YOU ARE SIGNING
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SIGNATURE
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Equipment
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ARTICLEVALUE
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Moving Insurance
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Every moving company is required to advise you that the purchaser should obtain insurance to protect himself from losses of goods or damage to real property. The customer's coverage for insurance is the standard sixty cents ($0.60) per pound per article.
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IMPORTANT
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(SIGN BEFORE START OF ANY SERVICE)
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The Customer, subject to and based on the rates, rules, regulations, and conditions hereby orders the carrier to furnish transportation facilities and service described herein subject to all conditions herein contained including valuation agreed or declared and the conditions on the back hereof which are hereby agreed to by the customer and accepted for himself and his assigns, unless credit arrangements are made in writing the customer agrees to pay charges in cash, money order, card, or certified check prior to complete delivery.Manly Moving offers Full Replacement or Repair Insurance at a rate of Ten Dollars per One Thousand Dollars of Coverage.
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$10,000
$10 per $1000 coverage
$100
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$20,000
$10 per $1000 coverage
$200
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Other
$10 per $1000 coverage
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Customer Agrees to purchase Additional Insurace
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CUSTOMER
TOTAL CHARGES
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SIGNATURE
ADVANCED DEPOSIT
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BALANCE DUE
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MOVERMANLY MOVING
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RECEIVED FULL PAYMENT
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 yes no
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DELIVERY RECEIPTMover:MANLY MOVING
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Except as specifically endorsed hereon all services and all articles received in good condition.
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Full Payment is due the day of the moving date. Under written and signed permission money is due two weeks after the said move job date at the latest.
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CUSTOMER
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SIGNATURE
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Thank you for choosing Manly Moving to take care of your moving needs!!!
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