Company_Profile_MWRegion-LA

SCHEDULE A – DESCRIPTION OF EQUIPMENT (One form per location)

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Exact Equipment Location (Physical Address): Same as seller information (Please circle one) Yes (skip to Loading Information) No (Provide equipment location below) Physical Address: _______________________________________ City: __________________________ State: _________ Zip Code: ________________________________ County: __________________________________ If no Physical Address: Latitude _________________________ Longitude _________________________________ Contact Name at Equipment Location: __________________________________ Phone: _____________________________ Loading Information: Loading Dock Available  Yes  No Assist with Loading  Yes  No If yes, is there a loading charge? $_____________ Will any of these lots require disassembly or specialized equipment for loadout? Yes No

Tracking ID

Item (Brief Description: Year, Make, Model

If Titled, Exact Name on Title

SN / VIN

Signature per name on Title

Seller: _______________________________________________ Date: _________________________ Printed Name of Legal Seller (as listed on page 1)

By: __________________________________________________ Signature of Owner / Representative

Name: ______________________________________________________ Printed Name of Signer

Title of Signer:_________________________________________

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Rev 01_2021e

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