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Request an Equipment Move

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Contact Name: *

Company Name: *

Email: *

Phone: *

Move FROM

Company Name:

Company Address: *

City: *

State / Region: *

Zip / Postal Code: *

Requested Pick-up: *

Please describe the details about the location of current equipment:

Move To

Company Name:

Company Address: *

City: *

State / Region: *

Zip / Postal Code: *

Requested Delivery: *

Please describe the details about the future location:

Equipment Information

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Equipment 2

Check to ADD Additional Equipment

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Equipment 3

Check to ADD Additional Equipment

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Equipment 4

Check to ADD Additional Equipment

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is:

Working
Not Working

Equipment 5

Check to ADD Additional Equipment

Manufacturer & Model:

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Equipment 6

Check to ADD Additional Equipment

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Equipment 7

Check to ADD Additional Equipment

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Equipment 8

Check to ADD Additional Equipment

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Equipment 9

Check to ADD Additional Equipment

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Equipment 10

Check to ADD Additional Equipment

Manufacturer & Model: *

Machine ID or Serial #:

Machine Type or Description:

The machine currently is: *

Working
Not Working

Please include any additional useful information:

Email

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Office Systems International
6055 N.W. 82 Avenue,
Miami, FL 33166
(305) 436-5600
rey@osimiami.com

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