State 2 State Auto Transport, Fullerton CA, 92831

Quotes: 800-715-4630 Dispatch: 714-447-4630 Fax: 888-499-6607

www.EasyCarShipping.com

Customer Name: ______

Address: ______

City: ______State: ______Zip: ______

Home Phone: ______Cell: ______other #: ______

Fax: ______Email: ______

Vehicle Information – Please supply as much information as possible

Year: ______Make: ______Model: ______

License Plate: ______VIN Number (last 6): ______Operable and running? Yes or No

Auto Auction information- Buyer # ______Lot/Stock # ______

Origin - Name and Location of where the vehicle is to be picked up from Desired Dates: ______

Name: ______Contact______

Address: ______

City: ______State: ______Zip: ______

Home Phone: ______Cell: ______other #: ______

Destination - Name and Location of where the vehicle is to be delivered Desired Dates: ______

Name: ______Contact______

Address: ______

City: ______State: ______Zip: ______

Home Phone: ______Cell: ______other #: ______

Additional Information - Use this space to note any special pick up and delivery info or vehicle information such as the vehicle is inoperable condition rolling and steering ______

______

Payment and Contract Terms and Conditions Information Summary

State 2 State Auto Transport accepts payments in the form Visa or Master Card credit cards, cashiers check, money order, cash, or cod (cash on delivery) paid to the driver. Deposits made are not charged until your vehicle is assigned to a transport carrier. The quoted rate includes pickup and delivery of vehicle. Should the vehicle become inoperative when the driver arrives or during transport of vehicle there is an additional charge of $150.00 that will be added to the total quoted rate.*We reserve the right to re-quote or adjust transport cost when deemed necessary.

Signature ______Date ______

State 2 State Auto Transport, Fullerton CA, 92831

Quotes: 800-715-4630 Dispatch: 714-447-4630 Fax: 888-499-6607

www.EasyCarShipping.com

Payment Information:

Please fill out this form for payment on your vehicle transport.

I will be paying a deposit between $90- $150.00 now and the balance due on delivery, in the form of:

Cash on delivery (cod) or cashiers check (bank check) or money order

*If you need to make other payment arrangements please call us to discuss*

Pick One: Visa MC

Card Number: ______

Expiration Date: ______Security Digits: ______

(Numbers on back of card, above signature -required)

Name on Credit Card: ______

(Your name, the way it appears on the Credit Card)

Billing Address: ______

City: ______State: ______Zip: ______

TOTAL $______(Entire transport cost as quoted by State 2 State)

A. Deposit Charge $______(Between $90-$150 on average)

B. On Delivery $______(COD due to the carrier at the time of delivery. Payable by cash or cashier’s check, payable to

the carrier whose name we will provide to you.)

A+B =Total Cost $______

Signature ______Date ______

Your Credit Card will not be charged until your vehicle is assigned to a carrier.

We have no cancellations fees unless you cancel after your vehicle is assign to a carrier. If other fees arise such as inoperable or a re-quote price you will be notified before the new charges are billed.

State 2 State Auto Transport, Fullerton CA, 92831

Quotes:800-715-4630or 714-447-4630 Fax: 888-499-6607

www.EasyCarShipping.com

TERMS AND CONDITIONS AND BROKER DISCLOSURE

· State 2 State Auto Transport or its carriers will not be responsible for any contents other then standard equipment left in the vehicle. Vehicle must be free of contents, unless agreed upon prior to pickup. Vehicles being sent internationally are subject to stricter standards.

· State 2 State strives to accommodate your pick-up and delivery needs. Although most transport occurs seamlessly, delivery dates and times are only an estimate. At times, delays may occur. Delays may be due to weather conditions, traffic or other issues that are not foreseen. State 2 State will schedule your transport within one to ten days after your booking is confirmed and order number is assigned. Most routes will take only a couple of days to be assigned and picked up. On some difficult routes, it may take longer than 10 days to assign and pick up your vehicle. We strive to accommodate your schedule.

· Customer is responsible for preparing the vehicle for transport. All loose parts, fragile or protruding accessories, low hanging spoilers, etc., need to be removed and/or properly secured. If the vehicle is modified (such as lowered, lifted, or extended)and cannot bealtered, such facts must be disclosedin writing toState 2 State Auto Transport in advance. Quote may be subject to change if vehicle is altered and has not been disclosed at time of original quote.

· Customer agrees that should this vehicle become inoperative for any reason during the transport, a charge of $150.00 will be added to the transport charges. This will be collected at the time of vehicle delivery or applied to Bill of Lading invoice. State 2 State Auto Transport or its carriers will not be responsible for damage caused by freezing engine, cooling system and/or batteries.

· We offer a door to door service, you will not need to drop off the vehicle at a terminal. Please note: with door to door transport, carrier will pick up and deliver your vehicle as close as possible to the addresses you provide. For safety reasons, if carrier feels they can’t enter your street or your neighborhood, they will ask to you to meet in safe location to load and unload. If customer is designating another person to meet carrier at time of pick up or drop off, it is the customer’s responsibility to make sure that designated person is aware of these terms.

· State 2 State is a licensed transportation broker and customer is aware that State 2 State will be acting as broker to transport their vehicle.As a Bonded Broker (MC-517651-B), we work with only reputable carriers who are properly licensed and insured. We have a well established base of courteous and professional carriers providing quality nationwide service.

· State 2 State will assign vehicle to a carrier. Carrier is responsible for any damage claim and State 2 State will work with customer and carrier to ensure that all legitimate claims will be processed and paid in a timely manner. State 2 State and its carriers are not responsible for damage caused by ACTS OF GOD such as hail or heavy storms or other uncontrollable weather conditions or events. Glass damage and small chips, scratches or minor damage that result from normal road conditions or normal wear and tear not related to negligence by the driver is not covered. State 2 State and its carrier are not responsible for mechanic failures unless negligence on the part of the carrier caused the mechanical failure. Please secure any loose parts or items on the vehicle prior to transport and notify State 2 State of any major oil or fluid leaks that you may know on your vehicle.

· Although it is rare that damage occurs while a vehicle is being transported. If damage should occur, all moneys owed for transport must be paid before initiating a claim.Damage must be noted directly on the Bill of Lading and signed by driver and shipper, regardless of weather or time of day.Signing of the Bill of Lading without any notation of damage verifies car was received in good condition. State 2 State Auto Transport and its carriers must be notified of any damage immediately and followed up in writing with a description of damage, written repair estimate(s) and clear photos of damage. These items must be submitted within 10 days to State 2 State by fax or email. Fax @ 888-499-6607 or email . State 2 State will provide carriers insurance certificate and carrier information upon request.

· Both customer and State 2 State Auto Transport agree to submit to the exclusive jurisdiction of the courts located within the County of Orange, California to resolve any legal matter arising from these Terms and Conditions. State 2 State Auto Transport can only be liable for up to the amount of the deposit paid.

· State 2 State Auto Transport has no cancellation fees should you cancel your transport prior to your vehicle(s) being assigned to a carrier.If an order is cancelled after it is assigned to a carrier, there will be a $100.00. Cancellation fee will be charged to credit card on file.

· Please sign and acknowledge the terms and conditions.If you have a question regarding any of these terms and conditions please contact us prior to submitting the order.

______

Customer signature Date

Please note: Electronic signature and or emailed orders also constitutes contract in effect.