The Moving Company

1234 Main St

Los Angeles CA 90000

Waiver Form: Pressed Wood Furniture

Customer/Shipper Name: ______________________________

Date_______________

Please take notice:

We notice that you have various household furnishing constructed of particle-board (also known as “pressed wood”).

This type of furniture is suspect of brakeage, cracking, dents, and related forms of damage following exercise of due care. The reason for this problem is the inherent weakness of the unstable wood product used in its construction.

The California MAX 4 Tariff, at Itcm 172 (mandated by the California public utilities commission for moves with an origin and destination in the state of California) as well as the 400m Tariff, item 36 (filed with the U.S. department of transportation, for moves with an origin and destination in different states) recognize these problems with this sort of furniture. According to the respective tariffs, a carrier (The Moving Company) is entitled to charge a disassembly and reassembly charge for these items at the prevailing hourly rates. We, at The Moving Company, realize that the original assembly of many of these products was completed with glue that would make disassembly highly complicated and require significant time.

Please select from the following options:

1.             Shipper(s) will disassemble the particle-board furniture or arrange for           it to be disassemble without the need of The Moving Company, and the furniture will be transported in flat boards, to be reassembled at destination by Shipper(s)

2.             Carrier (The Moving Company) will charge $___________disassemble and reassemble the following pieces of furniture________________________________________________________________

_______________________________________________________________________________

3.             Shipper authorizes Carrier to handle the job without moving the following pieces of furniture: _______________________________________________________________________________

_______________________________________________________________________________

Shipper will not pay additional money for the disassembly and reassembly, but has read the forgoing notice regarding the nature of particle-board furniture, and elects to have Carrier                       (The Moving Company) continue with the move without the additional safety precautions listed above. Accidental damage arising from the relocation of the sensitive furniture will not be the liability of The Moving Company acts  with due care in according with their obligations set forth under the applicable Laws, Regulations, and  Tariffs concerning this household goods relocation

Date: _________________     Signature: _________________________________

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