M. LANGE, Inc.

Specializing in moving of heavy equipment

900 Industrial Drive - Bensenville, IL - 60106

Ph: (630) 766-8807 - Fax: (630) 766-8549 E-mail: mail@mlangeinc.com

Please provide the following contact information and equipment information so we can quote you a price and serve you better: If you fill in your email address, a copy of this request will be sent to you.

All fields marked with an (*) must be completed in order for the form to be accepted.
Requester Information
* First Name:
* Last Name:
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* Company:
* Address:
Address (cont.)
* City:
* State:	ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WASHINGTON, D.C. WEST VIRGINIA WISCONSIN WYOMING
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Job Site Information (Check to use Requester Information above: )
* Company:
* Address:
Address (cont.)
* City:
* State:	ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WASHINGTON, D.C. WEST VIRGINIA WISCONSIN WYOMING
* Zip Code:
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* Type of Equipment:
Dimensions (Weight and MFG / Model:
* Location of equipment (floor, room, etc):
* Stairs?: (Yes / No)
Number of stairs:
* Brief scope of work:
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Company: (If location is the same write "SAME"
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City:
State:	ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WASHINGTON, D.C. WEST VIRGINIA WISCONSIN WYOMING
Zip Code:
Contact Person:
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