Special Hire Request Form

Important GIT Notice

Loads are dispatched without Goods in Transit (GIT) insurance or cover. Power Truck Hire does not offer GIT insurance. 

Your Details

Company Name: {name-1}
Contact Name: {text-1}
Contact Telephone Number: {phone-1}
Email Address: {email-1}

Collection Site

Collection Address: {textarea-1}
On-site Contact Name & Number: {text-2}
Who's responsible for loading?: {select-1}

Delivery Site

Delivery Address: {textarea-2}
On-site Contact Name & Number: {text-3}
Ground Surface Type: {select-2}
Overhead Obstructions: {select-3}
Detail Obstructions: {text-4}
Who's Responsible for offloading?: {select-4}

About the Load

Description of Load: {textarea-3}
Number if Items: {number-1}
Dimensions (L × W × H): {text-5}
Weight per item (kg): {text-6}
Value of Load (R): {text-7}
Equipment Needed: {radio-1}

Vehicle & Access

Vehicle & Access: {select-5}
Crane Mount Type: {select-6}
Indoors or Outdoors?: {select-7}
Distance from Truck (m): {text-8}
Need Crew from Us?: {select-8}
Need a Consultant to Assess the Load First?: {select-9}

Photos

Photos of the Load/Items: {upload-1}
Photos of the Collection Site: {upload-2}
Photo of the Delivery Site: {upload-3}