Business to Business

(Business to Business quotes only)

 RETURN QUOTE TO;

 LAST NAME:    

 FIRST NAME:

 E- MAIL ADDRESS:

 PHONE NUMBER:   FAX NUMBER:

SHIPMENT INFO

 COMPANY NAME:

 COMMODITY:        

  TOTAL WEIGHT :IN POUNDS     CLASS:  IF KNOWN 

                                    Air/Ocean weight Help        

 PALLETIZED:

            NUMBER OF PALLETS:     STACKABLE?

 LOOSE:

            NUMBER OF PACKAGES:

 SIZE IN INCHES (EACH PACKAGE OR PALLET) :

    (ONLY FILL IN ONE SET IF ALL PALLETS/PACKAGES ARE THE SAME)

                Length           Width           Height        

                (List additional sizes in comments if necessary)   

 RELEASE VALUE: 

 ORIGIN:

            CITY:    

            STATE: 

            ZIP:                

 DESTINATION:

            CITY:   

            STATE:

            ZIP:      

            COUNTRY:  

 P/U DATE             am  pm   

DELIVER ON/BY     am  pm

TIME CRITICAL ?:

 COMMENTS / SPECIAL SERVICES REQUIRED: 

 (Re-fer, Air-ride, Flatbed, Lowboy,  etc.)

             If you have problems with this form call 800 573-0105.