Primary Contact
Person: (This
is the person we will contact during the move)
Primary Phone
Number:
Primary Email
Address:
Requested Pickup
Date:
or
ASAP (As
Soon As Possible)
Last Date for
Pickup:
2. Vehicle
Information(Additional Vehicles
List In Comments Section or type in as follows: vehicle1/vehicle2. If you
have any questions, please call us at 800-355-0224.)
Year:
Make:
Model:
Color:
Full VIN
Number: (Hawaii
Only)
License
Number: (Hawaii
Only)
State
Licensed: (Hawaii
Only)
CoPart Buyer / Lot Number:
Condition Of
Vehicle:
Operates on own
power.
Does NOT operate on own
power.
NOTE:
Vehicles that are not in running condition must be prepaid in
full.
Type Of
Carrier:
Open
Carrier
Enclosed
Carrier
3. Pickup
Location
Name:
Address:
City:
State:
Zip
Code:
Home
Phone:
Work
Phone:
Cell
Phone:
Other
Phone:
4. Delivery
Location
Name:
Address:
City:
State:
Zip
Code:
Home
Phone:
Work
Phone:
Cell
Phone:
Other
Phone:
NOTE: Hawaii/Alaska moves
must have pickup and/or delivery at the port facility in Hawaii or Anchorage . All other moves are quoted as
Door to Door.
5. Payment
Options: (Please or The Appropriate Choices
Below)
Payment
Choice:
If you need
your order placed immediately please select the "deposit only"
option.
Deposit Only:
COD:
• The final payment must be
paid via Cash, Cashier’s Check, or Official Bank Check, made out to the
transporter NOT TO Progressive Auto Transport. Payment options available
are prepayment in full or deposit amount that was quoted. If the amount is
left blank or states anything other than the deposit amount shown on your
quote, the amount of the deposit shown on your quote will be
charged.
If you are
placing your order by pre-payment in full please select this option. You
will need to fill out the full payment authorization letter and fax or
scan and email the letter with your order.
Pre-Payment In Full:
Special
Circumstance Payment: If you start by choosing the
"deposit only" option and you wish to make final payment before the
vehicle is delivered, you may do so by filling out the "full payment
authorization letter" below for the remaining balance. Please note in the
space provided on the authorization letter that you have paid the initial
deposit.
•
Please
Note: Any credit card or Pay Pal
charge that exceeds $160.00 per vehicle but less than $1,000.00 per
vehicle will be subject to a $25.00 Internal Processing Fee per vehicle.
Any Credit Card or Pay Pal charge that is $1,000.00 or more per vehicle
but less than $2,000.00 per vehicle will be subject to a $50.00 Internal
Processing Fee per vehicle. Any credit card or Pay Pal charge that meets
or exceeds $2,000.00 per vehicle will be subject to a $75.00 Internal
Processing Fee per vehicle. This fee is nonrefundable if this order is
canceled, for any reason, after being assigned to a
Carrier.
Other Optional
Services:
Terminal Service at Pickup:
Call
for Price.
Terminal Service at Delivery:
Call
for Price.
6. Credit Card
Information
Form Of
Payment:
*Check By Fax:
Just
fax, mail, or email us a copy of your completed personal or company check.
Cashiers Checks, Money Orders, Official Bank Checks, etc. must be mailed.
Checks will be charged using ACH technology.
PayPal Email
Address: (If
Applicable)
Credit Card
Number: (i.e.
1111-2222-3333-4444)
Expiration
Date: (i.e.
19/07)
Customer Service
Number: (Found
on back of card. This is for security purposes to show you have possession
of the actual card. i.e. 1-123-123-4567)
Security
Number: (This
is found on back of card, and is normally in the signature area of your
card. This will be the last 3-4 digits found in the signature area of your
credit card.)
Name As Shown On
Card: (Must
be name EXACTLY as shown on card. i.e. John F. Smith)
Cardholder Billing
Address: (This
is the address where the credit card company sends your bill
to.)
Cardholder Zip
Code: (This
is the zip code where the credit card company sends your bill
to.)
Is the cardholder the shipper
of the vehicle?
Yes No
Do you have permission to use
the card?
Yes No
Type of
Card:
Credit
Card Debit
Card
7. Contract Terms
& Conditions
PROGRESSIVE TRANSPORTATION CORP. STANDARD CONTRACT
TERMS & CONDITIONS:
This order and any shipment hereunder is subject
to all forms and conditions of carrier’s tariffs to the uniform straight
bill of lading, copies of which are available to owners/shippers at the
office of carrier and are incorporated herein by reference and made part
hereof.
Notice: The owner’s/shipper’s or authorized
agent’s signature, at origin is also release which authorizes carrier to
drive owner’s/shipper’s vehicle other at origin or destination between
the point(s) of loading/unloading and the point(s) of
pick-up/delivery.
The carrier does not guarantee delivery on any
particular schedule. This and other items of the contract of carriage
are governed by the uniform straight bill of lading herein.
Owner’s/shipper’s vehicle(s) will be placed in a local storage facility
if owner/shipper of his/her agent is not available to receive the
vehicle upon carrier’s arrival for delivery. Owner/shipper will be
responsible for any storage and/or additional delivery fees
incurred.
It is PROGRESSIVE TRANSPORTATION CORP’s policy
to leave all vehicles unlocked during transportation.
If owner/shipper desires fire, theft and
collision coverage, owner/shipper must carry same.
Carrier’s responsibility for the described
vehicle(s) commences when the bill of lading is issued and signed by the
driver and terminates when designated vehicle(s) is signed for at
destination.
Owner/shipper shall designate a person to act as
his/her agent at the point of pick-up and/or delivery if for any reason
he/she is unavailable.
By owner’s/shipper signature or his/her agent’s
signature, PROGRESSIVE TRANSPORTATION CORP, and carrier’s driver or
agents, jointly and separately are authorized to operate and transport
the vehicle(s) from the point of origin specified on the reverse side to
the point of departure and to the specified final destination via any
mode.
All monies must be in the form of a cashier’s
check, or in the case of delivery, cash may also be presented. Personal
checks will NOT be accepted and orders will not be processed and cars
will be subject to storage fees if they are at any point presented for
payment and proper funds are not available. If, for any reason beyond
carrier’s control, owner/shipper fails to claim vehicle(s) after
attempted notification of arrival, the shipment will be subject to a
lien for unpaid storage and transportation costs.
Th carrier does not agree to transport shipments
on any particular truck or by any particular driver, or in time for any
particular market and will not be responsible for consequential loss or
damage occasioned by delay or damage. There are absolutely no guarantees
made, expressed or implied, regarding pick-up and/or delivery times or
dates. Carrier will not be held responsible for any non-use of the
vehicle charges, including but not limited to, car rental(s), interest,
floor planning, or any other charges due to delay or damage.
ICC regulations limit service to the
transportation of the vehicle only. Carrier may not accept any personal
effects inside the vehicle or trunk area. This regulation cannot be
waived. Any charges or fines or damage resulting from this will be the
shipper’s responsibility. Personal belongings left in the vehicle are
not insured by broker or carrier and are shipped at the
owner’s/shipper’s risk.
Owner/shipper certifies that the vehicle(s)
contain no personal belongings.
The following items are not to be in the vehicle
at time of shipment: Guns, explosives, ammunition, inflammable products,
narcotics, negotiable and legal papers, alcoholic beverages, jewelry,
furs, money, other articles of unusual value, pets, live plants, or
contraband.
Owner/shipper of all non-operational vehicles
tendered for transportation will be charged an additional $150.00 to
$200.00. If a vehicle is rendered for shipment and later becomes
non-operational, the $150.00 to $200.00 fee will be added onto the
amount to be collected, as well as any other charges necessary to
accomplish delivery. Owner/shipper may be required to pick up vehicle at
a terminal facility if additional fees are due upon delivery.
Nothing in this agreement shall be construed as
making it binding on carrier to pick-up and/or deliver at locations from
or to which it is impractical to operate carrier’s equipment on account
of condition of highways, streets, or other passageways or inadequate
loading or unloading facilities.
Carrier or broker will not knowingly transport
any vehicle which is uninsured as to liability incurred in its
operation. If vehicle is not insured, and owner/shipper fails to notify
shipper of such, carrier will not be held responsible for any claim
against owner/shipper or itself, and owner/shipper will be sued for any
damages which may occur.
If vehicle is vandalized either during shipment
or while awaiting shipment, neither broker or carrier will be held
responsible. Owner/shipper agrees his/her insurance shall be responsible
for any claims of this kind.
If there is any claim problem upon delivery, all
charges must be paid before a claim can commence. All damages must be
properly noted in writing in the presence of the driver. Signing of the
Bill of Lading at destination, without immediate notation of alleged
damage, shall be evidence of satisfactory delivery of vehicle.
Regardless of weather or time of day, vehicle examination is the
responsibility of the receiver.
No claims shall be accepted unless noted upon
delivery of vehicle in the presence of the driver. Claims must be made
within 15 days or shall be waived.
Should owner/shipper commence legal action
against PROGRESSIVE TRANSPORTATION CORP. and not prevail, then
PROGRESSIVE TRANSPORTATION CORP. will be entitled to reimbursement for
all its attorney fees and court costs.
Owner/shipper is responsible for preparing
vehicle for shipment. All loose parts, fragile or protruding
accessories, low hanging spoilers, fog lights, antennas, etc., must be
removed and/or properly secured. Any part of vehicle that falls off
during transit is owner’s/shipper’s responsibility, including damages
caused by said part to any and all vehicles involved.
Owner/shipper agrees to allow PROGRESSIVE
TRANSPORTATION CORP. to act as its broker or agent in dealing with
carriers, and to exercise its efforts on owner’s/shipper’s behalf and
placing the order with a transport company. Said transport company will
route vehicles from origin to destination by a suitable route and does
not agree to any specific routing. PROGRESSIVE TRANSPORTATION CORP.
cannot make any guarantees for exact delivery time or day. PROGRESSIVE
TRANSPORTATION CORP. does not guarantee performance of trucking company
and shall not be responsible for the same.
Owner/shipper understands that his/her shipment
is also subject to the terms and conditions of the specific trucking
company’s agreements.
Any claim for damages arising out of the use of
a truck to deliver owner/shipper’s vehicle must be taken up directly
with the trucking company. If there is any damage, the liability for
same lies solely with the trucking company. PROGRESSIVE TRANSPORTATION
CORP. will furnish owner/shipper with the name and phone number of the
trucking company used for transport, and will assist owner/shipper in
providing any other necessary information, should a claim arise. All
calls regarding damages or claims must be made to the trucking company
assigned by PROGRESSIVE TRANSPORTATION CORP. THE MAXIMUM LIABILITY IS
$25,000.00 PER VEHICLE. Owner/shipper additionally agrees that his/her
insurance company has the primary responsibility under his/her
comprehensive coverage and the owner’s/shipper’s insurance shall possess
no subrogation claim against broker or carrier in the event of an
accident or damages to the vehicle. Any claim or controversy arising
from or relating to this agreement, of the performance or breeched
thereof, shall be subject to the jurisdiction of CLARK COUNTY, KAHOKA,
MO. Owner/shipper specifically waives any right to jurisdiction of this
matter at any location other than Clark County, Kahoka, MO.
PROGRESSIVE TRANSPORTATION CORP.’s insurance
coverage is not in effect while the vehicle is at any terminal location
or while it is being driven to or from points of loading or unloading.
The same applies to any drop location. Owner’s/shipper’s insurance is in
full effect when the vehicle is not in the exclusive possession of the
carrier.
If any claim is made, the carrier has the right
to take the vehicle to a licensed body shop of carrier’s choice for
repairs.
PROGRESSIVE TRANSPORTATION CORP. claims all
salvage rights.
If you place an order with us, you
have the option to cancel any time prior to your vehicle being assigned
to a transporter at no cost to you. If your vehicle is booked on a
transporter before you fax or email your cancellation, you will lose the
amount of the deposit and wiring fee if applicable. Any canceled order
that was paid in full or going to or from Hawaii or Alaska will lose the wiring fee (if
applicable) regardless of booking status. If your vehicle is not made
available to the assigned carrier, the wiring fee will be held as a dry
run fee.
Owner/shipper is responsible for all fuel
necessary to complete pick-up and delivery in either or both services
requested. Otherwise, the vehicle shall be tendered with no more than 1
tank of fuel. If sufficient fuel is not provided, it will be purchased,
and shipper/owner shall pay with the same as added charges.
8. Agreement:(NOTE: There must be
a in the box
below before you can submit this form.)
I agree to the terms and conditions of Progressive Auto
Transport found in section 8 of this form. By submitting this form, I
agree to allow Progressive Auto Transport to have my vehicle(s)
transported and to allow Progressive Auto Transport to deduct the
authorized amount from the credit card chosen in this
order.
9. Questions or
Comments:Please describe in
detail about your vehicle (oversize tires, lift kits, extended cabs,
toppers, lights mounted on roof, ski racks, ladders, dually,
etc.)
I
plan on putting approximately lbs. of items in the
trunk / cargo area of my vehicle ONLY.* * Vehicles being
shipped to or from Hawaii or Alaska MUST be free of
personal belongings.