To Consignee
From Shipper
Name *
Address 1 *
Address 2
City *
State *
Zip *
Phone
Name *
Address 1 *
Address 2
City *
State *
Zip *
Phone
Reference Numbers
Shipper's Number
P.O. Number
Quote Number
Delivering Carrier
Freight Charges
You must select either prepaid or collect.
Billing Terms *
Prepaid
Collect
Optional Third Party Bill-To
You only need to fill out the third party bill-to address if the invoice should be sent to an address other than the shipper's or consignee's address.
Name
Address 1
Address 2
City
State
Zip
COD
If you do need to use a COD, you must select at least one acceptable payment method. You must also indicate whether the fee charged for the collection of the COD is prepaid or collect.
COD Amount
Acceptable Payment Methods
Certified Check
Company Check
COD Fee To Be
Prepaid
Collect
Remit COD To Different Address?
You only need to fill out the "remit COD to" address if the COD check should be returned to someone other than the shipper.
Name
Address 1
Address 2
City
State
Zip
Items Shipped
All freight must have units, description, class and weight.
If you do not know the freight class, choose class 999 but please provide a detailed description or NMFC number.
If the line item is hazardous, it must have a U.N. number.
Lines containing invalid information will remain
red
until completed correctly.
Handling
Units (Pcs)
Description
Class
Weight
Haz-
Mat
Hazard
Class
U.N.
Number
Packing
Group
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
50
55
60
65
70
77.5
85
92.5
100
110
125
150
175
200
250
300
400
500
999
The pallet number is not required, but if your shipment is on a definite number of pallets, please provide the count.
Total # of pallets
Are the pallets shrink wrapped?
This field is required only if you provide a pallet count. Otherwise, please do not choose either "Yes" or "No".
Yes
No
Hazmat Emergency Phone #
Declared Value
Per
Special Instructions
Maximum 180 characters.
0
