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Customer Intake Form

Currency

US CDN

Name And Contact:

First Name

Last Name

Company/Farm

Cell Number

Mailing Address:

Street

City

Province/State

Postal/Zip

Full Pickup Address If Different Than Above

Contact: (ONLY this number will be contacted for pick up)

Full Delivery Address and Contact If Different Than Above

Contact: (ONLY this number will be contacted for dilivery)

Stall Size

Regular ½ Boxstall Full Boxstall

Horse Name, Age, Sex, Oher Importatant Info

Preferred Shipping Date

PAYMENT METHOD (PAYMENT IS REQUIRED IN FULL PRIOR TO PICK UP.)

Invoice will be sent day before shipping

PLEASE NOTE:

ALL CROSS BOARDER SHIPMENTS, CUSTOMER/SHIPPER IS REQUIRED TO PREPARE ALL NECESSARY DOCUMENTS TO MEET CBSA REQUIREMENTS IN ADVANCE OF SHIPPING FOR CROSS BORDER WE MAY REQUIRE FURTHER PERSONAL INFORMATION AS PER REQUIRMENTS OF EACH COUNTRY FOR US ENTRIES, A SSN OR FARM TAX ID IS MANDATORY

FOR CANADA ENTRIES, PROOF OF RETURNING CAD HORES PAPERWORK OR A BILL OF SALE IS MANDATORY

PLEASE READ THE FOLLOWING TERMS & CONDITIONS, & SIGN YOUR ACKNOWLEDGEMENT

Publicity Permission for Pacific Northwest Equine Transport Ltd.:
Please Acknowledge that photos and/or videos of your horse may be used on our social media and/or for advertising purposes. Please Initial

Loading / Unloading Limitations:
Loading / Unloading must be completed within 60 minutes from time of our arrival. Any Loading / Unloading not completed within 60 minutes will require an additional $125.00 per hour or if we leave due to mutual agreement a flat fee of $250 is charged. Please Initial

Excessive damage to the truck or trailer or equipment caused by your equine.
We will fairly estimate the cost of repairing the damage at delivery. If the actual cost is more or less than, we will supply you with the written estimate or bill. & make any necessary adjustments with you. Please Initial

Deposit:
We may require a 50% deposit for new clients, due upon signing & submitting this contract to reserve your spot(s) on the trailer.
In an event your horse does not load or is becoming dangerous to transporter & / or trailer, & / or appears sick we reserve the right to not load your horse & transport, in these cases your deposit is non-refundable. Cancellations of less than 48 hours will forfeit any & all monies paid toward transport. Any deposits made will be less $20 servicing fee. Please Initial

Veterinary Care Costs:
In the event your horse should need veterinary care, Pacific Northwest Equine Transport Ltd. will make every effort to contact you. If we can not contact you & we deem necessary for the good will or your horse, we will make the decisions ourself. Please Initial

Release:
Owner hereby voluntarily releases & forever discharges Pacific Northwest Transport Ltd. from any & all liabilities, claims, demands, actions or rights of actions, which are related to, rise out of, or are in any way connected with the transport, care or feeding, any & all injury, illness or disease, death & damage of the mentioned equine(s) including, but not limited to the negligent acts or omissions of Pacific Northwest Transport. If the owner elects not to secure other insurance, then he/she agrees that he/she assumes all expenses or liabilities associated with the transport or care of the aforementioned equine(s). Owner hereby holds harmless Pacific Northwest Transport Ltd. for any liability that would incur for property damage or bodily injury to any equine(s) & /or owners/passengers loading, transporting, unloading, or handling the mentioned equine(s). Please Initial

Entire Agreement:
Horse Owner understands that this is the entire agreement between Equine Owner & Pacific Northwest Equine Transport Ltd., its agents or employees, & it supersedes & cannot be modified or changed in anyway the representations or statements of any agent or employee of Pacific Northwest Equine Transport Ltd. or Equine Owner. My signature below indicates that I have read this entire document, understand & it completely, & agree to be bound by its terms in its entirety. By submitting this agreement it is considered legal & enforceable.

Owner / Shipper SIgnature

Date

UPON DELIVERY:
Received in good health X

Customer Signature

Date

Office Use Only: