Rate Request Proposal
Company Name*
 
Contact*
E-Mail*
Address
 
City*
State/Province*
Phone (including area code)*
Fax (including area code)*
Origin*
Postal Code-ZIP*
Destination*
Postal Code-ZIP*
Actual Weight*
Number*
Kgs Lbs
Pieces Skids
Dimensions*
Stackable*
L W H Yes No
Commodity*
Class Number
Please select one:
Temperature Control: Reefer Heater No
Dangerous Goods: Yes No
Tail Gate Required: Yes No
Type of Service: Road Intermodal
Declared Value: Yes No
If Yes, Enter Amount:
USD CDN
Require Customs Service: Yes No
Country of Manufacture:
Required only if Customs service is required.