Customer Name:  _______________________________________________________________

 Phone#:  ________________________  Fax#:  _________________________

 Delivery Address:  ________________________________________________

Billing Address:  __________________________________________________

 Contact Person:  Purchasing:  ______________  Warehouse: _____________

 Please Check Method of Unloading Material:

 Overhead crane__________Fork lift rear____________Fork lift side____________

 Hand Unloading inside__________Hand Unloading outside______________

 Please Indicate Acceptable Weight in Pounds:

 Minimum Skid:  _____________              Maximum Skid:  _______________

              Receiving Days:  _____________               Receiving Hours:  ______________

              Width Tolerance:  ____________                Gauge Tolerance:  _______________

              Length Tolerance:  ___________           Diagonal Tolerance:  _____________

 Slit Coil Information: I.D. ________    O.D.  ________ (Max Weight in lbs) ________

 Unloading Information:    Eye to Sky _______                      Eye to Side _______

 Delivery Appointment Required:        YES     or         NO

Receiving Hours: ________________________________

 Special Information:  _____________________________________________________________

________________________________________________________________________

 Please note: Basic Metals’ payment terms are ½% 10 days Net 30.

AUTHORIZED SIGNATURE:  ____________________________________________

  DATE:  ____________________________________________