Holywell Grab & Skip Hire

Online Order

Please use this form for both TRADE & DOMESTIC orders.
We will contact you to confirm a price and availability.
However, if you prefer, please do not hesitate to telephone us on to discuss your requirement.
If you wish us to price a tender or would like to open an account please contact us by

phone: 01442 259622 - fax:01442 259622 - or email:

info@holywellhaulage.com

Contact Details

	Hirer Details
Company or name :
Address :
City :
Post Code :
Contact Name :
Telephone :
Fax :
Email :

	Delivery Details (if different)
Company or name :
Address :
City :
Post Code :
Contact Name :
Telephone :
Fax :
Email :

Vehicle / Container details

Mini Skip - 2 yard	4 yard	6 yard	8 yard
10 yard	12 yard	Roll on/off	Grab Loader
On Road	Off Road

Dates

Delivery Date

AM PM

Preferred payment method

Cheque (with bankers card)

Cash

Card

Comments and other requirements