1-877-392-7831
e-Waste,LLC
1261 Hudson Gate Drive
Hudson, OH 44236
Phone:330-650-0274 Fax:330-650-0597
www.e-wasteonline.com
Date: 05th September, 2010
Liquidation Form
End User Information:
Company:
Contact Name:
Address:
City/State/Zip:
Phone:
Email:
Units
Manufacture:
Model:
# Units:
Unit Condition:
Description:
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
New
Like New
Used
Poor
Non Working
Project Info:
Project Start Date:
Project End Date:
Equip. Palletized:
Yes
No
Loading Dock:
Yes
No
Internal Quoting Use Only:
Quote Notes
Equipment Value:
Valid Until:
Net Terms:
Remarketing Signature:
Date:
Manager Signature:
Date: