Moving Customer Acknowledgment

Customer  Acknowledgment

Please READ, initial the necessary places, & sign at the bottom of this page.

All Moves: (Local & Long Distance):

• The company will not be responsible for any items packed by the customer. Contents & condition of boxes will not be covered by our liability                        INITIALS  x _______

• I hereby release Hercules Van Lines of any responsibility in the handling and transportation of all uncrated mirrors, marble, pictures, glass tops, lamps, lampshades, box springs, mattresses, and all other unpacked fragile items.                                 INITIALS  x ________

• Electrical and mechanical condition of all appliances, such as refrigerators, televisions, stereos, washers dryers, etc. is unknown and will not be covered.      INITIALS  x ________

• PRESSED WOOD – the company will not responsible for ANY Pressed wood furniture. Elected to be taken by the customer.                                                  INITIALS  x ________

• Customer agrees if charges are not paid in full prior to delivery, shipment will go into local storage and customer will responsible to all charges.                          INITIALS  x ________

• I have accompanied the Forman in a walk-through of my residence in order to verify all origin services are complete & all items were taken.                             INITIALS  x _______

• I have signed and received a copy of the carrier bill of lading, inventory sheets addendum and packing materials list.                                                                          INITIALS  x _______

Customer Signature: _________________________

Date: __________________________

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