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Company:
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You are the:	Consignee Shipper 3rd Party
Origin City, State:
Origin Zip:
Destination City, State:
Destination Zip:
Service Requested:	2nd Day AM 2nd Day PM 3-5 Day Next Day AM Next Day PM Same Day Other
If other, please describe:
Shipment ready time	Date: Time:
Delivery deadline	Date: Time:
Total Pieces:
Total Weight:
Please indicate dimensions (in inches) using the following format: Numer of Pieces @ Length __ x Width __ x Height __
(Example) 2 @ 48" x 36" x 36" 1 @ 24" x 24" x 24"
Check if you are shipping dangerous goods:
Declared Value:	DECLARED VALUE FOR LOSS OR DAMAGE NOT TO EXCEED $50.00 UNLESS GREATER VALUE DECLARED HERE AND EXTRA CHARGES PAID.
Value for Customs:	required for international shipments
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Select vehicle size (required for expedited ground service):	Panel van (maximum weight = 2000 lbs.) Cube van (maximum weight = 3500 lbs.) 24' Straight truck (maximum weight = 10,500 lbs.) Semi (maximum weight = 45,000 lbs.)