CHECK ONE BOX: 1- Kansas Highway Patrol 1- Kansas Wildlife & Parks 1- Kansas Dept. of Transportation 1- Other (Specify)

INVITATION TO AND ACCEPTANCE

(Bid or Estimate)

COMMERICAL MOVING VAN SERVICES (K.C.C. AUTHORIZED CARRIER ONLY)

(Name of Carrier) (Address) (Carrier Representative)

(Telephone Number) (Fax Number) (Signature)

To furnish labor, equipment, tools, containers, etc. necessary to pack and transport safely and without harm household goods and effects belonging to

,

an employee of

from St, KS.,

to St, KS.,

and there to unpack and place as directed by

Date of move will be or such other date as agreed upon

between the shipper listed above and/or their representative and the carrier.

/ MATERIALS PURCHASED /
ESTIMATED COST OF CONTAINERS AND PACKING AND UNPACKING SERVICES / ESTIMATED NUMBER / PER EACH / TOTAL / ESTIMATED NUMBER / PER EACH / TOTAL
BARREL, dish-pack, drum, etc. / $ / $
CARTONS:
1 ½ cubic feet
3 cubic feet
4 ½ cubic feet
6 cubic feet
WARDROBE CARTON
CRIB MATTRESS CARTON
MATTRESS CARTON (Not exceeding 39” x 75”)
MATTRESS CARTON (Not exceeding 54” x 75”)
MATTRESS CARTON (Exceeding 54” x 75”)
MATTRESS COVER (plastic or paper)
OTHER
CORRUGATED CONTAINERS (Specially designed for mirrors, paintings, glass or marble tops and similar fragile articles)
CRATES (Specially constructed for mirrors, paintings, glass or marble tops and similar fragile articles)
Gross measurement of crate
ESTIMATED MATERIAL COSTS / $ / ESTIMATED PACKING COSTS / $

ESTIMATED COST OF SERVICE

Transportation: Est. wt. lbs.: mi: @ $ per 100 lbs $

Transit Valuation of not to exceed protection

at value to $1.25 per lb., $15,000 limit per shipment $ cost per $100.00 Total insurance coverage

On Storage in Transit @ cents per CWT (10% of monthly storage rate for each 30 days or fraction thereof)

Additional transportation charges: (explain)

Pickup or delivery for storage in transit lbs @ $ per 100 lbs.

Storage in transit* at lbs. @ cents per 100 lbs.{for each 30 days or fraction thereof}

Warehouse handling lbs @ cents per 100 lbs. (ONE TIME CHARGE)

Extra pickup or delivery at

Special servicing of appliances

Hoisting, lowering or carrying pianos, heavy articles (explain)

Materials and Packing (see above)

Labor man/men for hrs @ (per man hour)

Other services (explain)

* Storage over 30 days will not be paid or reimbursed by the State of Kansas TOTAL ESTIMATED COST $

LIMITATIONS: 1. Yard toys, patio equipment, window air conditioners, shelving, etc, must be disassembled or removed by the owner and ready to be loaded.

2. Additional services not listed above and not authorized by the State of Kansas must be paid in advance by the employee.

3. Employee will be reimbursed for actual quantify of weight of goods moved or services provided, up to 12,000 pounds.

1 THIS IS A FIRM BID. THE STATE OF KANSAS WILL PAY THE MOVING COMPANY. (Kansas Highway Patrol and Dept. of Corrections Only).

Where payment of services is made by the State of Kansas directly to the carrier, bids will be exempt under K.S.A. 66-152; Agency Authorized Official

the bidder is required to make a firm bid and is not required to conform to tariffs filed with the K.C.C. Bill of Landing submitted for

payment will show total cost identical with total firm bid quote above and will be mailed to .

1 THIS IS NOT A FIRM BID BUT ONLY AN ESTIMATE

The State of Kansas will not pay the moving company direct but will reimburse the employee subject to the limitations shown

above. Employee will pay the moving company direct based on tariffs and/or discounts on file with the K.C.C. for services actually performed. Agency Authorized Official

Mover shall provide the employee a detailed bill of lading which includes actual weight moved.

TABLE OF MEASUREMENTS
Articles To Be Shipped / Articles Not
To Be Shipped / Articles / CubicFeet PerPiece / No. Of Pieces / Cu. Ft. / Articles To
Be Shipped / Articles Not
To Be Shipped / Articles / Cubic Feet
Per Piece / No. of Pieces / Cu.
Ft. / Articles To Be Shipped / Articles Not
To Be shipped / Articles / Cubic Feet
Per Piece / No. of Pieces / Cu. Ft.
LIVING AND FAMILY ROOMS
/
NURSERY
/
MISCELLANEOUS
Bar, Portable 15 / Crib, Baby 10 / Clothes, Hamper 5
Bench, Fireside or piano 5 / Table, Child 5 / Cot, Folding 10
Bookcase 20 / Pen, Play 10 / Desk, Office 30
Bookshelves, Sectional 5 / Rug, Large or Pad 10 / Fan 5
Chair, Arm 10 / Rug, Small or Pad 3 / Fernery/Plant Stands 10
Chair, Occasional 15 / Foot Lockers 5
Chair, Overstuffed 25 /
KITCHEN
/ Garbage Cans 7
Chair, Rocker 12 / Breakfast, Suite Chairs 5 / Golf Bag 2
Chair, Straight 5 / Breakfast Table 10 / Heater, Gas/Electric 5
Clock, Grandfather 20 / Chair, High 5 / Incinerator 10
Day Bed 30 / Ironing Board 2 / Metal Shelves 5
Desk, Small or Winthrop 22 / Kitchen Cabinet 30 / Ping Pong Table 20
Desk, Secretary 35 / Roaster 5 / Pool Table 40
Fireplace Equipment 5 / Serving Cart 15 / Power Tools 20
Foot Stool 2 / Stool 3 / Sewing Machine 10
Lamp, Floor or Pole 3 / Table 5 / Sled 2
Magazine Rack 2 / Utility Cabinet 10 / Step Ladder 5
Music Cabinet 10 / Vegetable Bin 3 / Suitcase 5
Piano, Baby, Gr, or Upr. 70 / Table, Utility 5
Piano, Parlor Grand 80 / Tackle Box 1
Piano, Spinet 60 / Tool Chest 10
Radio, Table 2 / APPLIANCES (Large) / Tricycle 5
Record Player Port. 2 / Air Conditioner, Window 30 / Wagon, Child’s 5
Rugs, Large Roll or Pad 10 / Dehumidifier 10 / Waste Paper Basket 2
Rugs, Small Roll or Pad 3 / Dishwasher 20 / Work Bench 20
Sofa, 2 Cushions 35 / Dryer, Electric or Gas 25
Sofa, 3 Cushions 50 / Freezer; (Cu. Capacity)
Sofa, 4 Cushions 60 / 10 or less 30
Sofa, Sectional. Per Sect. 30 / 11 to 15 45 / OTHER ITEMS (Specify)
Stereo 20 / 16 and over 60
Stud, Couch or Hideabed 50 / Ironer or Mangle 12
Tables, Droplf or Occas. 12 / Range, Electric or Gas 30
Tables, Coffee, End or Nest 5 / Refrigerator; (Cu. Capacity)
Telephone Stand & Chair 5 / 6 cu. ft. or less 30
Television Combination 25 / 7 to 10 cu. ft. 45
T.V. or Radio Console 15 / 11 cu. ft. and over 60
Television Table Model 10 / Vacuum Cleaner 5
Washing Machine 25
DINING ROOM
Bench, Harvest 10 /
CONTAINERS
Buffet 30 /
OUTDOOR FURNITURE
/ (Packed by Shipper)
Cabinet, Corner 20 / & EQUIPMENT / Barrels 10
Cabinet, China 25 / Barbecue or Port. Grill 10 / Boxes, Wooden 3
Chair, Dining 5 / Bath, Bird 5 / Boxes, Wooden 5
Server 15 / Chairs, Lawn 5 / Boxes, Wooden 10
Table, Dining 30 / Chairs, Porch 10 / Boxes, Wooden 15
Tea Cart 10 / Clothes Line 5 / Boxes, Wooden 20
Rugs, Large or Pad 10 / Clothes Dryer Rack 5 / Carton
Rugs, Small or Pad 3 / Garden Hose and Tools 10 / Less then 1 ½ cu. ft.
Glider or Settee 20 / 1 ½ cu. ft.
Ladder, Extension 10 / 3 cu. ft.
BEDROOM
/ Lawn Mower (Hand) 5 / 4 ½ cu. ft.
Bed., incl. Spring & Mattr: / Lawn Mower (Power) 15 / 6 cu. ft.
Bed, Double 60 / Lawn Mower (Riding) 35 / 6 ½ cu. ft.
Bed, King Size 70 / Leaf Sweeper 5 / Wardrobe Furnished by Carrier 15
Bed, Sing. or Hollywood 40 / Outdoor Child’s Slide 10 /
CONTAINERS
Bed, Rollaway 20 / Outdoor Child’s Gym 20 / (Packed by Carrier)
Bed, Bunk (set of 2) 70 / Outdoor Drying Racks 5 / Barrels 10
Bookshelves, Sectional 5 / Outdoor Swings 30 / Boxes, Wooden 3
Bureau, Dresser, Chest 25
Of Dr’w’rs, Chifrb. Or chifnr / Picnic Table 20 / Boxes, Wooden 5
Cedar Chest 15 / Picnic Bench 5 / Boxes, Wooden 10
Chair Boudoir 10 / Porch Chair 10 / Boxes, Wooden 15
Chair, Straight or Rocker 5 / Rocker, Swing 15 / Boxes, Wooden 20
Chaise Lounge 25 / Roller, Lawn 15 / Carton
Desk, Small or Withrop 22 / Rug, Large 7 / Less than 1 ½ cu. ft.
Dresser or Vanity Bench 3 / Rug, Small 3 / 1 ½ cu. ft.
Dresser Double (Mr&Mrs) 50 / Sand Box 10 / 3 cu. ft.
Night Table 5 / Settee 20 / 4 ½ cu. ft.
Rug, Large or Pad 10 / Spreader 1 / 6 cu. ft.
Rug, Small or Pad 3 / Table 10 / 6 ½ cu. ft.
Vanity Dresser 20 / Umbrella 5 / Wardrobe Furnished by Carrier15
Wardrobe, Small 20 / Wheel Barrow 8 / Sub Total Col. 3
Wardrobe, Large 40 / Total Col. 1
Total Col. 2
MISCELLANEOUS
/ Total Col. 3
Ash or Trash Can 7 / GRAND TOTAL
NURSERY
/ Basket (Clothes) 5 / Summary
______cu. ft. @ ______lbs.per cu. ft. _____lbs.
Estimated Total Weight ______lbs.
Bathinette 5 / Bicycle 10
Bed, Youth 30 / Bird Cage & Stand 5
Chair, Child’s 3 / Card Table 1
Chair, High 5 / Cabinet, Filing 20
Chest 12 / Carriage, Baby 20
Chest, Toy 5 / Chairs, Folding 1
Sub. Total Col. 1 / Sub. Total Col. 2