QUOTE REQUEST FORM FOR FULL TRUCKLOAD (FTL/TL) AND SKIDS/PALLETS (LTL)

Carol Boniuk and Miguel Cordoba Global Tranz Team m. 469 884-9317 and 713 519-7176 c.boniuk@globaltranz.com and m.cordoba@globaltranz.com

COMPANY INFORMATION

COMPANY LEGAL NAME *

STREET *

APARTMENT, SUITE, ETC *

CITY *

PROVINCE/STATE *

ZIP/POSTAL CODE *

COUNTRY *

CONTACT NAME *

CONTACT EMAIL *

CONTACT TEL *

PICKUP LOCATION

SAME AS ABOVEYes

IF DIFFERENT PLEASE INDICATE THE PICKUP ADDRESS:

PICKUP ADDRESS:

STREET

CITY

PROVINCE/STATE

ZIP/POSTAL CODE

DELIVERY LOCATION

RECEIVER BUSINESS NAME *

STREET NAME *

CITY *

STATE/PROVINCE *

ZIP/POSTAL CODE *

RECEIVER CONTACT NAME *

RECEIVER CONTACT EMAIL *

RECEIVER CONTACT TEL *

IS THIS SHIPMENT A FULL TRUCKLOAD?YesNo

IF yes complete the next three fields

WHAT IS THE COMMODITY

WHAT IS THE VALUE OF THE LOAD

WHAT TYPE OF TRUCK DO YOU NEED

WHAT IS THE PICKUP DATE:

IS THIS AN LTL SHIPMENT (1-6 SKIDS)?YesNo

If yes, complete the following fields

Length (in)

Width (in)

Height (in)

Weight (lbs)

How many skids are there in total?

WHAT IS THE COMMODITY

WHAT IS THE PICKUP DATE

PLEASE CLICK ANY/ALL ACCESSORIALS REQUIREDLiftgate at pickupLiftgate at deliveryPickup appointment requiredDelivery appointment requiredRefrigerated serviceAdditional insurance (please enter details below if yes)Inside deliveryResidential deliveryHazmat

SPECIAL INTRUCTIONS/COMMENTS