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Shipper Information
Name
Address1
Address2
City
Phone
Ext:
Contact
Shipper Order#
Customer PO#
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Consignee Information
Name
Address1
Address2
City
Phone
Contact
COD Amount
Declared Value
Company Check
OK?
PCS
WGT
Description
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Service
Priority
Standard
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Freight Charge
Bill to Shipper
Bill to Consignee
Bill 3rd Party
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Ready Time
Close Time
Special equipment. Check if apply
Lift Gate
Pallet Jack
Inside Pickup
Enter measurements if any one dimension exceed 120 inches in length or 60 in width or height or special instructions in box below
