CDW Pickup RequestJob Type* Re-Source Partners to pick up at my site We will ship to Re-Source PartnersLocation*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/ CMATracking NumberEquipment DetailsEsitmated QuantityProduct TypeQuanityModel Description Does Equipment Have a BIOS or Hard Drive PasswordYesNoEnter Password*The following is required for Pickup Jobs OnlyLoading Dock AvailableYesNoDock NumberDock Hours*Grade Level Door Available?YesNoTractor Trailer Accessible?YesNoLiftgate Truck Required?YesNoManifest UploadsAccepted file types: csv, xlsx, xlsm, xml, txt, pdf, jpeg, doc, png, xls.Manifest UploadsAccepted file types: csv, xlsx, xlsm, xml, txt, pdf, jpeg, doc, png, xls.Manifest UploadsAccepted file types: csv, xlsx, xlsm, xml, txt, pdf, jpeg, doc, png, xls.What Floor is Equipment On?Elevator AvailableYesNoIs Equipment Consolidated?*YesNoIs Equipment At Dock?*YesNo(If No) Eqipment LocationIs Equipment on Pallets?YesNoEstimated Pallet CountEquipment Shrinkwrapped*YesNoPickup CommentsSpecific Pick-up/Ship Date Requested?YesNoIf Yes is selected, 3rd Party Freight charges may applyRequested Pick-up/Ship DateRequested and Authorized By First Last Requested by Email Address Portfolio/ProfileCDW
