Collection and Delivery Booking Form

"*" indicates required fields

About you

Name*

First Last

Email address*

Contact number*

Alternative contact name

In case we cannot get hold of you a any point on the day of he job is there someone else we can contact who can act in your stead?

First Last

Alternative contact phone number

About your collection/delivery

Job date*

Job details

Estimated job cost

This is your final estimated balance, including VAT. The final balance in full could be lower or higher due (but not limited) to supplementary costs incurred or the job taking less or more time to complete than anticipated.

What time is the job?*

Addresses

Address 1

Hidden

Postcode or place name*

Collection/delivery address 1*

Street Address Town / City / County Postcode

Collection/delivery address 1*

Street Address Town / City / County Postcode

Make this the billing address?

Yes, this is the billing address

Collection or Delivery?*

Collection

Delivery

What are we collecting?*

Please provide full details of what you want us to collect and where from.

What are the items? Quantity? Approximate size and weight? Which floor we are collecting from? Is there anything we need to know about access to/inside the collection venue?

What are we delivering?*

Please provide full details of what you want us to deliver and where to.

What are the items? Quantity? Approximate size and weight? Which floor we are delivering to? Is there anything we need to know about access to/inside the delivery venue?

Would you like us to do any furniture disassembly/reassembly at this address?*

I would like Rocketvan to disassemble/reassemble furniture where necessary at this address

Furniture disassembly/reassembly is not required at this address

Parking information*

If you do not have a valid Residents’ Permit you will need to apply for a Parking Suspension. We can arrange this for you for a £25 (plus VAT) surcharge.

Do you want to add another collection or delivery address?

Yes, I would like to add another address

Address 2

Hidden

Postcode or place name*

Collection/delivery address 2*

Street Address Town / City / County Postcode

Collection/delivery address 2*

Street Address Town / City / County Postcode

Make this the billing address?

Yes, this is the billing address

Collection or Delivery?*

Collection

Delivery

What are we collecting?*

What are we delivering?*

Would you like us to do any furniture disassembly/reassembly at this address?*

I would like Rocketvan to disassemble/reassemble furniture where necessary at this address

Furniture disassembly/reassembly is not required at this address

Parking information*

If you do not have a valid Residents’ Permit you will need to apply for a Parking Suspension. We can arrange this for you for a £25 (plus VAT) surcharge.

Do you want to add another collection or delivery address?

Yes, I would like to add another address

Address 3

Hidden

Postcode or place name*

Collection/delivery address 3*

Street Address Town / City / County Postcode

Collection/delivery address 3*

Street Address Town / City / County Postcode

Make this the billing address?

Yes, this is the billing address

Collection or Delivery?*

Collection

Delivery

What are we collecting?*

What are we delivering?*

Would you like us to do any furniture disassembly/reassembly at this address?*

I would like Rocketvan to disassemble/reassemble furniture where necessary at this address

Furniture disassembly/reassembly is not required at this address

Parking information*

If you do not have a valid Residents’ Permit you will need to apply for a Parking Suspension. We can arrange this for you for a £25 (plus VAT) surcharge.

Do you want to add another collection or delivery address?

Yes, I would like to add another address

Address 4

Hidden

Postcode or place name*

Collection/delivery address 4*

Street Address Town / City / County Postcode

Collection/delivery address 4*

Street Address Town / City / County Postcode

Make this the billing address?

Yes, this is the billing address

Collection or Delivery?*

Collection

Delivery

What are we collecting?*

What are we delivering?*

Would you like us to do any furniture disassembly/reassembly at this address?*

I would like Rocketvan to disassemble/reassemble furniture where necessary at this address

Furniture disassembly/reassembly is not required at this address

Parking information*

If you do not have a valid Residents’ Permit you will need to apply for a Parking Suspension. We can arrange this for you for a £25 (plus VAT) surcharge.

Do you want to add another collection or delivery address?

Yes, I would like to add another address

Address 5

Hidden

Postcode or place name*

Collection/delivery address 5*

Street Address Town / City / County Postcode

Collection/delivery address 5*

Street Address Town / City / County Postcode

Make this the billing address?

Yes, this is the billing address

Collection or Delivery?*

Collection

Delivery

What are we collecting?*

What are we delivering?*

Would you like us to do any furniture disassembly/reassembly at this address?*

I would like Rocketvan to disassemble/reassemble furniture where necessary at this address

Furniture disassembly/reassembly is not required at this address

Parking information*

If you do not have a valid Residents’ Permit you will need to apply for a Parking Suspension. We can arrange this for you for a £25 (plus VAT) surcharge.

Do you want to add another collection or delivery address?

Yes, I would like to add another address

Address 6

Hidden

Postcode or place name*

Collection/delivery address 6*

Street Address Town / City / County Postcode

Collection/delivery address 6*

Street Address Town / City / County Postcode

Make this the billing address?

Yes, this is the billing address

Collection or Delivery?*

Collection

Delivery

What are we collecting?*

What are we delivering?*

Would you like us to do any furniture disassembly/reassembly at this address?*

I would like Rocketvan to disassemble/reassemble furniture where necessary at this address

Furniture disassembly/reassembly is not required at this address

Parking information*

If you do not have a valid Residents’ Permit you will need to apply for a Parking Suspension. We can arrange this for you for a £25 (plus VAT) surcharge.

Do you want to add another collection or delivery address?

Yes, I would like to add another address

Address 7

Hidden

Postcode or place name*

Collection/delivery address 7*

Street Address Town / City / County Postcode

Collection/delivery address 7*

Street Address Town / City / County Postcode

Make this the billing address?

Yes, this is the billing address

Collection or Delivery?*

Collection

Delivery

What are we collecting?*

What are we delivering?*

Would you like us to do any furniture disassembly/reassembly at this address?*

I would like Rocketvan to disassemble/reassemble furniture where necessary at this address

Furniture disassembly/reassembly is not required at this address

Parking information*

If you do not have a valid Residents’ Permit you will need to apply for a Parking Suspension. We can arrange this for you for a £25 (plus VAT) surcharge.

Do you want to add another collection or delivery address?

Yes, I would like to add another address

Address 8

Hidden

Postcode or place name*

Collection/delivery address 8*

Street Address Town / City / County Postcode

Collection/delivery address 8*

Street Address Town / City / County Postcode

Make this the billing address?

Yes, this is the billing address

Collection or Delivery?*

Collection

Delivery

What are we collecting?*

What are we delivering?*

Would you like us to do any furniture disassembly/reassembly at this address?*

I would like Rocketvan to disassemble/reassemble furniture where necessary at this address

Furniture disassembly/reassembly is not required at this address

Parking information*

If you do not have a valid Residents’ Permit you will need to apply for a Parking Suspension. We can arrange this for you for a £25 (plus VAT) surcharge.

Liability

Quotations/estimates provided for each job and its acceptance by you are subject to our Terms and Conditions. We would particularly draw your attention to Clause 4 and Clauses 9 to 12, which cover our liability to you in the event of loss or damage.

The price(s) we quote include(s) Limited Liability for loss of or damage to your goods whilst they are in our custody and control. Limited liability offers a maximum compensation of £40 per item as set out in Clauses 9.2 and 9.4 of our terms and conditions.

We can accept Standard Liability subject to you providing us with a declaration of the value of your goods and subject to Clauses 9.1 and 11 of our Terms and Conditions. We would draw your attention to the items for which we will not accept liability, and to the exclusions which apply to our liability.

If you would like us to accept standard liability our price(s) will be increased as outlined below to reflect the higher level of liability.

Our liability is a contractual agreement between you and us. If you wish us to carry out any service or move goods which are specifically excluded by these conditions, you must have our written agreement before signing this contract.

Cover for Goods in Transit or Storage – Optional Increased Liability

You need to declare the total value of goods to be moved and/or stored. If you would like to increase your level of liability from Limited (as detailed above) to Standard Liability you will need to confirm the increase and your acceptance of the relevant level of liability by checking the boxes below. The cost for this depends on the value of the goods. For example, if the declared total value of goods is £23,500, you will need to check the box that allows compensation up to £25,000. If the declared total value of goods is £74,000, you will need to check the box that allows compensation up to £75,000.

Please note, you are not automatically entitled to compensation to the value declared in this acceptance form for any claim for loss or damage. Any claim for loss or damage in transit or storage will be assessed by a loss adjustor, where proof of purchase, condition and value for any item claimed for may be required before a settlement is made.

Declaration of Value*

I declare that the total value of the items to be removed and/or stored is:

Liability Supplements

Goods in Transit and Storage – Level of Liability*

I agree to accept Limited Liability for the Removal (and Storage) only

I would like to increase Limited Liability to Standard Liability

In the event of any damage you will only be entitled to compensation up to a maximum of £40 per item.

Goods in Transit Liability*

I agree to increase Limited Liability to Standard Liability, to the value declared above, subject to a maximum of £25,000 at a cost of £25 plus VAT per move

Goods in Transit Liability*

I agree to increase Limited Liability to Standard Liability, to the value declared above, subject to a maximum of £50,000 at a cost of £50 plus VAT per move

Goods in Transit Liability*

I agree to increase Limited Liability to Standard Liability, to the value declared above, subject to a maximum of £75,000 at a cost of £75 plus VAT per move

Goods in Transit Liability*

I agree to increase Limited Liability to Standard Liability, to the value declared above, subject to a maximum of £100,000 at a cost of £100 plus VAT per move

Goods in Transit Liability*

I agree to increase Limited Liability to Standard Liability, to the value declared above, subject to a maximum of £150,000 at a cost of £150 plus VAT per move

Goods in Transit Liability*

I agree to increase Limited Liability to Standard Liability, to the value declared above, subject to a maximum of £200,000 at a cost of £200 plus VAT per move

Goods in Transit Liability*

I agree to increase Limited Liability to Standard Liability, to the value declared above, subject to a maximum of £250,000 at a cost of £250 plus VAT per move

Goods in Transit Increased Liability – over £250,000 total value

The total value of your items exceeds our standard liability levels. We are able to accept liability for values exceeding £1,000,000 subject to the agreement of our insurers and an additional charge.

We will be in touch to discuss your particular requirements.

Hidden

Goods in Transit Liability*

Contact client regarding total value over £250,000

Goods in Storage Liability*

I agree to increase your Limited Liability to Standard Liability to an overall value of £25,000, at a cost of £25 plus VAT per month, for the duration of my storage contract

Goods in Storage Liability*

I agree to increase your Limited Liability to Standard Liability cover to an overall value of £50,000, at a cost of £50 plus VAT per month, for the duration of my storage contract

Goods in Storage Liability*

I agree to increase your Limited Liability to Standard Liability to an overall value of £75,000, at a cost of £75 plus VAT per month, for the duration of my storage contract

Goods in Storage Liability*

I agree to increase your Limited Liability to Standard Liability to an overall value of £100,000, at a cost of £100 plus VAT per month, for the duration of my storage contract

Goods in Storage Increased Liability – over £100,000 total value

Compensation for any declared value in excess of GBP 100,000 for goods in storage will be subject to our insurers agreement and an additional charge.

We will be in touch to discuss your particular requirements.

Hidden

Goods in Storage Liability*

Contact client regarding total value over £100,000

Items of significance

If you have any items of particular significance, please indicate each item’s value, either in monetary amount (in GBP) or that it is of personal/sentimental value.

Hidden

End Liability Section

Confirmations

Billing Address*

Please supply your billing address if different to the addresses above.

Street Address Town / City / County Postcode

Address Confirmation*

Rocketvan undertakes this job based on the address information you have provided on this form. Rocketvan will charge for any extra time taken travelling to incorrect addresses.

I hereby confirm that the address information given above is correct. I understand that I am liable for extra charges if Rocketvan travel to addresses given in error.

Terms and Conditions*

You will have received a copy of the Rocketvan Terms and Conditions with your Booking email. Please confirm that you have read, understood and agree to them in full. If you are in any doubt please do not hesitate to get in touch with us on 020 7401 3928 and we will be happy to go over them with you.

I confirm that I have received your Terms and Conditions of contract. I have read and accept the same. I declare that I have full authority to enter into this contract. I agree to pay the balance in full, upon completion of the works/receipt of invoice in accordance with Clause 8 of Rocketvan’s terms and conditions.

Payment Confirmation*

Your final estimated balance is , including VAT. The final balance in full could be lower or higher due (but not limited) to supplementary costs incurred or the job taking less or more time to complete than anticipated. Please confirm your understanding and that you agree in full to Rocketvan’s payment terms.

I agree in full with Rocketvan’s payment terms and I agree to pay the final balance in full upon completion of the works/receipt of invoice, in accordance with clause 8 of Rocketvan’s Terms and Conditions.

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