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Routine Delivery
Point of Contact Detail
First Name
Last name
Email
Area Code
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Phone #
Scope Detail
Origin
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Destination
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Are there any changes to the pick or delivery Address?
Are styrofoam shippers required
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Are there any special delivery instructions?
How many styrofoam shippers are required?
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How many pounds (lbs.) of dry ice is required for each box?
25 lbs.
50 lbs.
more than 50 lbs.
If more than 50lbs of dry ice is required per box, or quantity exceeds 5 boxes, please provide details.
Delivery Details
Delivery Date
Delivery Time
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