RATE REQUEST

 

 

 

 

 

 

 

COMPANY NAME:     _____________________________________________________________

 

STREET ADDRESS:   _____________________________________________________________

 

SUITE/ROOM #:       _____________________________________________________________

 

CITY:                     _____________________________________________________________

 

STATE:                   _____________________________________________________________

 

ZIP CODE:              ______________________ COUNTRY: _____________________________

 

PHONE #:               _________________________________________ EXT. #: _____________

 

FAX #:                    _____________________________________________________________

 

E-MAIL ADDRESS:     _____________________________________________________________

 

 

 

COMMODITY:          _____________________________________________________________

 

ORIGIN:                  _____________________________________________________________

 

DESTINATION:         _____________________________________________________________

 

Please specify dimension and weight of each piece (including packaging):

 

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

_____ @ ________ (L) x ________ (W) x ________ (H)            ____________ KILOS / LBS

 

 

Please specify mode of transportation:

 

______ AIR                       ______ SEA                       ______ LAND

 

 

Special handling / instructions:

 

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

 

 

PLEASE FAX ABOVE INFORMATION TO +1 (516) 616-7676.  THANK YOU.