DUKE QUOTE / ORDER FORM Which Duke Store Should the Quote / Order Be Forwarded to?Store Name* Rochester Ithaca Dansville Auburn Select* Quote Form Order Form Taken By:* First Last Date* MM slash DD slash YYYY Time* : Hours Minutes AM PM AM/PM Delivery InformationDelivery Date* MM slash DD slash YYYY Delivery Time* : Hours Minutes AM PM AM/PM Customer InformationExisting or New Customer?* Existing Customer New Customer Customer NumberAccount with Duke: Yes / No?* Yes No Customer Name* Contact (Person Placing Order)* First Last Customer Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Customer PhoneCustomer Mobile*Job Site / Ship To:Job Name:* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Job Site Contact:* First Last Cell:*Job Site Email:* Job # Purchase Order # Which Customer Should the Quote / Order Be Emailed to?Customer Email Address Rental / Sale Item(s)Item 1Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (1)* Yes No Item 2Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (2) Yes No Item 3Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (3) Yes No Item 4Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (4) Yes No Item 5Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (5) Yes No Item 6Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (6) Yes No Item 7Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (7) Yes No Item 8Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (8) Yes No Item 9Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsAdditional Item to Add? (9) Yes No Item 10Quantity Model # Unit # Description* Sales $*Day $*Week $*Month $*Length of Rental Day Week Month Days1 Day2 Days3 Days4 Days5 Days6 Days7 Days8 Days9 Days10 DaysWeeks1 Week2 Weeks3 Weeks4 Weeks5 Weeks6 Weeks7 Weeks8 Weeks9 Weeks10 WeeksMonth(s)1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 MonthsCartage FeesDelivery $*Pick Up $*Special Delivery Instructions Δ