CDW Pickup Request Job Type* Re-Source Partners to pick up at my site We will ship to Re-Source Partners Location* Site Name* Pick Up Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Primary ContactName* First Last Phone*Email* Secondary ContactName First Last PhoneEmail PO Number/ CMA Tracking Number Equipment DetailsEsitmated QuantityProduct TypeQuanityModel Description Does Equipment Have a BIOS or Hard Drive Password Yes No Enter Password* The following is required for Pickup Jobs OnlyLoading Dock Available Yes No Dock Number Dock Hours* Grade Level Door Available? Yes No Tractor Trailer Accessible? Yes No Liftgate Truck Required? Yes No Manifest UploadsAccepted file types: csv, xlsx, xlsm, xml, txt, pdf, jpeg, doc, png, xls, Max. file size: 64 MB.Manifest UploadsAccepted file types: csv, xlsx, xlsm, xml, txt, pdf, jpeg, doc, png, xls, Max. file size: 64 MB.Manifest UploadsAccepted file types: csv, xlsx, xlsm, xml, txt, pdf, jpeg, doc, png, xls, Max. file size: 64 MB.What Floor is Equipment On? Elevator Available Yes No Is Equipment Consolidated?* Yes No Is Equipment At Dock?* Yes No (If No) Eqipment Location Is Equipment on Pallets? Yes No Estimated Pallet Count Equipment Shrinkwrapped* Yes No Pickup CommentsSpecific Pick-up/Ship Date Requested? Yes No If Yes is selected, 3rd Party Freight charges may applyRequested Pick-up/Ship Date Requested and Authorized By First Last Requested by Email Address Portfolio/ProfileCDW
