Company Information
Company name
Contact name
Phone number
Fax number
Email
Origin of Shipment
City/Town
State/Province
Destination of Shipment
City/Town
State/Province
Description of Shipment
Description of shipment
Pieces
Number of pieces 
Length
Width
Height
Total weight

Description of commodity

(Ex: Packaging material)
Special insurance

Yes No

Hazardous materials Yes No
C.O.D shipment

Yes No

Other
Service level

Standard, less-then-truckload

Rush, less-then-truckload

Expedited, exclusive

Type of equipment
For Pickup (Check if applicable)
Lift gate required
Driver assist at origin
Residential area
Pickup appointment
Construction site
Trade show pickup

For Delivery (Check if applicable)
Lift gate required
Driver assist at destination
Residential area
Delivery appointment
Construction site
Trade show delivery
Other Special Instructions
Upon receiving the quote, you will also be given a quotation number.
Please keep this quotation number and have it noted on your bill of lading at time of pickup.

 
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