EPH Sales Rep:*

Your Email:*

Please provide your email for a copy of this order (once submitted)

Client Name:*

Please Specify:*

Load End
Tip End
On Site

Start Date:*

Date of Job Commencement

Quote Number:

If applicable

Site Address:*

Please provide details of the exact lcoation of site

Street Address (Must include Street Number) City

Additional Information Regarding Site:*

Must include: site contact, UHF, Entry point/Gate Number and Muster Point (if required)

Equipment Required:*

Please list type, number of Tippers or Plant and note any attachments required.

Type	Quantity	Any Attachments?

Start Time:*

Exact time of commencement

:

If start times vary, please specify:

Material Carting:

Please specify:*

Charge Rate:*

What are we charging the customer?

Breakdown:

What is the breakdown of costs?
- Day rate to client
- Loads
- Volume per load
- Truck pay rate
- Truck net earnings
- MUST INCLUDE MARGIN OF PAY RATE IN WORKINGS

Operator Pay:

What are we paying the operator (in their hand)

Estimated Duration:*

Length of job (please specify in weeks or days)

Load Site:

If 'Other' please provide the exact location of the site

Tip Site:

If 'Other' please provide the exact location of the site

Civil sites must include Full address and Job Details (including buyback)

Charge and Pay?*

Material Cost
Contribution
N/A

Charge:

Pay:

PO Number Required?*

Yes
No

PO Number:*

Site Contact*

Name and Contact Number

Order Contact*

Name and Contact Number

Email Contact (Quote Recipient)

Please enter the email address for the quote recipient

New Job Order