Thank you for choosing Stukel Mountain!


Please complete the following form to place a new shipping order or quote request.


This is an/a:
                          Order              Quote   


Shippers Information:
Company Name



Contact First Name                        Contact Last Name

         


Office Phone                                   Cell Phone

         


Email Address




Accounting Information:

Contact First Name                        Contact Last Name

         


Phone #                                              Email Address

         


Invoicing Requirements




Shipment Details

Pickup Information

Earliest Pickup                                      Latest Pickup

                           


Location Type



Address                                                   Address 2

         


City                                                            State                            Zip Code       

                  


Lot# / PO# / PRO# / Ref# / Etc.      Buyer # (If applicable)                 

         


POC Name                                              POC Phone

         



Delivery Information

Earliest Delivery:                                  Latest Delivery

                           


Location Type



Address                                                   Address 2

               

City                                                           State                            Zip Code

                        


Delivery # (PO, PRO, Etc.)



POC Name                                               POC Phone

               


Shipment Details:

Declared Value   $


Full Truck Load         Partial Truck Load   

Pieces                 Freight Class                 Liftgate                 Team   

Equipment Type                 

Commodity Description   

Length:        Feet            Inches
                           

Width:          Feet            Inches
                           
Height:         Feet           Inches
                           

Weight:     

Special Instructions, Appointment Notes, or Additional Information:




Terms & Conditions:
The applicant(s) executing this Application and Agreement (*Customer*) hereby agree(s) that payment for all services is subject to the following terms and conditions:
1. Customer agrees that all amounts due for services provided by “Stukel Mountain, LLC”
and/or any of its subsidiaries or affiliates, (collectively the “Company) are payable at Stukel Mountain, LLC 2700 Washburn Way, Suite B-2, Klamath Falls, OR 97603
2. Customer agrees that all amounts due are not payable in installments, but are payable (Net 15)
days from date of invoice. Company reserves the right to demand payment of all past due freight charges as a precondition for releasing any shipment(s) at destination. This right includes theright to demand payment upon delivery of shipment(s) at any time. If any amount due is not paid within said period, a delinquency charge of 5% per month of the delinquent balance shall beadded to the sum due.
3. In the event the Account becomes delinquent and is turned over for collection, Customer agrees
to pay all costs of collection including reasonable attorney fees and court costs. It is agreed that customer will become C.O.D if customer fails to pay terms.
4. Customer agrees to notify Company by certified mail of any changes in ownership of Customer
and further agrees to be liable for all losses incurred as a result of failure to comply with said notifications.
5. Customer authorizes the Company and/or its Credit Agency(s) to investigate all credit history,
bank reference and any other information required to process this application and as it deems necessary in the future.
6. Person accepting this document is an authorized representative and has authority to execute this
document.