Hudson Moving & Storage

HUDSON
Moving & Storage Co., Inc.

REGISTRATION

Student Storage & Shipping

YOUR INFORMATION
Name:
Email:
Cell Phone:
Institution:
Student ID:
Class:

HOME ADDRESS
Address:
City/State/Zip:
Phone:

SUMMER ADDRESS (if different)
Address:
City/State/Zip:
Phone:

STORAGE PICK-UP May 13 thru May 15, 2009 8:30AM - 4:00PM
PICK UP INFORMATION
Date:
Time:
Loc:

STORAGE DELIVERY September 8 thru September 11, 2009 8:30AM - 4:00:PM
DELIVERY INFORMATION
Date:
Time:
Loc:

All Items Must Be Boxed And Labeled
With The Last Name Printed And Lot # Top And Side Of Box.

Boxes
1.
2.
3.
4.
5.
6.

Dimensions
1.
2.
3.
4.
5.
6.

Use box below for additional boxes or furniture

Other: furniture, shelving etc., please list with dimensions

INSURANCE

Optional: Additional Insurance Coverage.

The liability of the warehouseman as to each package stored is limited to the actual value of each package, but not to exceed five times the amount of the base monthly storage rate per package stored unless the warehouseman is specifically notified by the bailor of a higher valuation per package in which event increased rates may be charged. Such notification shall be in writing and shall be sent by registered mail or in person within reasonable time after receipt of this warehouse receipt. The sole effect of a declaration of higher value, and the payment of the extra charge shall be to increase the maximum liability of the warehouseman per package up to the amount of the actual value per package, but all other terms and conditions of this contract shall remain unaffected thereby. In no case shall the liability be extended any loss of profit.

Insurance is $20.00 per $1,000 of declared value for replacement cost protection; $500.00 deductible. This fee is payable upon bringing goods into storage, and it will appear on your monthly storage invoice.

	Yes, I elect this insurance
	No, I do not elect this insurance

PARENT or GUARDIAN INFORMATION
Name:
Address:
Home Phone:
Work Phone:

Name:
Address:
Home Phone:
Work Phone:

PERSON(S) AUTHORIZED TO ENTER UPON/RETRIEVE YOUR PROPERTY

Please fill in this section if you are authorizing someone else other than yourself to enter upon or retrieve your property. No one else will be allowed to retrieve storage area unless this information is fill in. If you give such authorization we will request proper identification prior to granting retrieval of property.

Name:
Relationship:

Name:
Relationship:

Name:
Relationship:

Tenant Responsibility

I UNDERSTAND THAT: Hudson Moving & Storage requires me to pay in full my monthly storage bill. I understand that if my payment is late, I will be charged a late fee of 1.5% per month. Hudson Moving & Storage will not accept for storage any live/perishable items, drugs/alcohol or weapons/firearms of any kind. I will not have access to my storage lot except for dates and hours listed above unless all charges and any other fees are PAID IN FULL. Hudson Moving & Storage reserves the right to deny me access until all non-cash payments have cleared the bank. Access to storage lots are on dates previously listed only. No exceptions please.

I understand that if a check is returned unpaid for any reason, there will be a THIRTY-FIVE DOLLAR ($35) fee charged to my account as well as any applicable late fees. Hudson Moving & Storage accepts cash, credit card (MasterCard or Visa) or certified check on all goods going out of storage and for curbside pick-up. Personal checks are accepted if cleared by bank in advance. Personal checks also accepted on incoming storage accounts.

I agree to the above

Customer Security Endorsement

I certify that this storage lot and/or shipment does not contain any unauthorized or illegal firearms, weapons, explosives, destructive or flammable devices, illegal substances, liquor, food, plants or any perishable items. I am aware that this endorsement along with other company documents will be retained on file until shipment is delivered out.

Form of Payment: Credit card, check, cash upon coming into storage.

I have carefully read the terms and conditions on this storage contract and agree to abide by all of the terms as outlined above.

Thank you for filling out the form!
Click Submit if you are finished.

HUDSON
Moving & Storage Co., Inc.
3270 Broadway • New York, NY 10027
(212) 678-4862 • (800) 251-6465 • Fax: (212) 678-4617

email: hudson@moving-storage.com

Hudson Moving & Storage is 100% woman-owned