Delivery Form

Today's Date

Date

Delivery Date (Closed Sunday's)

Date

Full Name*

First NameLast Name

Phone Number*

Format: (000) 000-0000.

E-mail*

example@example.com

Pickup Address*

Street Address

Street Address Line 2

CityState

Zip Code

YesNo

What floor?

Delivery Address*

Street Address

Street Address Line 2

CityState

Zip Code

YesNo

What floor?

Transaction number if applicable

Is your item manufactured by Broyhill Furniture Company*

Please select item(s) if not on the list please type in the Special Delivery Instructions box.

Special Delivery Instructions: Please put anything we need to know about your delivery here or if your items for pickup or not listed above. If your item is already selected and no additional items are purchased type n/a.*

Please select a delivery timeframe. Please note delivery times are approximate. We will do everything within our ability to meet the selected times. In very rare events it may be necessary to delay or reschedule due to unforeseen circumstance *

File Upload

We accept debit card, credit card, cash and online payments.

Customer to measure rooms, doorways, hallways, and address anything that may obstruct the path of the movers.

Items that do not fit or do not meet your standards for any reason will incure a redelivery fee back to the place of origin. (Under no circumstances is your delivery free).

Neither the store or the delivery service is responsible for mercandise that does not fit.

Customer is responsible for payment of delivery and/or returning merchandise to the retailer.

Floor model furniture is purchased at your own risk. We do not assume, nor are we responsible for the condition prior to or after your delivery. This includes furniture purchased at any going out of business or clearance sales. Any furniture made with particle board/chipboard is exempt from any claim and no damages will be paid. In the event of a claim we pay .60 per pound for damage. No other payment or replacement other than what is listed in this paragraph.

SHOULD YOU HAVE ANY QUESTIONS OR NEED ANY INFORMATION ABOUT YOUR DELIVERY, CALL OR TEXT 918 361-1694. THE STORE OR PICKUP LOCATIONS ARE NOT ABLE TO ASSIST YOU WITH DELIVERY INFORMATION.

You have read and agree*

Signature*