Delivery Request Form
Contact 613 617 9671 or jason@veloz.ca for assistance
Pickup
Delivery
Enter delivery address with postal code. Eg 360 Laurier Ave W, Ottawa, ON K1P 1C8
Instructions
Suite number, buzzer code, customer info, etc.
Date
*
-
Month
-
Day
Year
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
# of ppl
*
Return
Member
*
Please Select
Jason
Paul
Johnny
Arif
Stephane
POD
*
Status
Please Select
Completed
Cancelled
Pending
Delivery Charge
Return Charge
Price
hst not included
Submit
Should be Empty: