Itemized Customer Survey/Inventory

Customer
Albert Benchimol High Five 111 Harrington Sound Road Smiths Phone: 1 917 224 2480 Email:Albert.Benchimol@axiscapital.com

Total Estimated Weight:9803

Total Estimated Cubic Feet:1508.5

Total # of Items: 153

Items Inventory

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#	Item Description	CFT	CP #	PBO#	Comment
10	Picture	30	10	0
3	Mirror	16.5	3	0
3	Desk	105	3	0
2	Desk, Small or Winthrop	54	2	0
2	Bookshelves, Sectional	24	2	0
10	Dining Chair	150	10	0
4	Stool	16	4	0
2	TV	18	2	0
1	Table, Dining	42	1	0
3	Rugs, Large Roll or Pad	36	3	0
2	Bench	24	2	0
1	Table	6	1	0
1	Umbrella	6	1	0
2	Couch	54	2	0
2	Chair, Arm	42	2	0
1	Coffee Table	20	1	0	Glass
8	Night Table	48	8	0
2	Rugs, Small Roll or Pad	8	2	0
2	Tables, Coffee, End or Nest	18	2	0
2	Coffee Table	40	2	0
7	Chair, Occasional	84	7	0
1	Bed frame	16	1	0
1	Crib, Baby	12	1	0
3	Chair, office	48	3	0
3	Lamp, Floor or Pole	12	3	0
2	Night Table	12	2	0	Glass
2	Bicycle	34	2	0
1	Golf Bag/Clubs	6	1	0
1	Computer	7	1	0
1	Stereo	12	1	0
2	Speaker	18	2	0
4	Surfing Board	64	4	0
6	Chair, Arm	126	6	0
30	Cartons, China Barrels	150	30	0
20	Cartons, Medium	60	20	0
6	Cartons, Stand-Up Wardrobe	90	6	0

Total Cubic Feet: 1508.5 Total Weight:9803

Carrier Packing & Crating Summary

Carrier Pack

#	Item Description	Room
30	Cartons, China Barrels	---------
20	Cartons, Medium	---------
6	Cartons, Stand-Up Wardrobe	---------

Packing

Item Description	Cartons #	Pack-CP #	PBO #
Cartons, China Barrels	30	30	0
Cartons, Medium	20	20	0
Cartons, Stand-Up Wardrobe	6	6	0

Signing below acknoledges receipt an estimate of your move based on the Table of Measurments. Only the items listed are included in the cost. Any items added or additional services may result in additional cost.

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Customer Signature

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Date