Request for Rate Quotation
         REQUEST FOR RATE QUOTATION

Please complete this entire form so we may best assist you with an as accurate rate quote as possible, thank you:

 

SHIPPER INFORMATION

Contact Name:
Title:
Company Name:
Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal Code:
Country:
Telephone:
Fax:
E-mail:
Website Address:

Are you a:

Shipper | Forwarder | Consignee | Customs Broker | N.V.O.C.C.

Return Rate Request by:

E-mail | Telephone | Fax

CARGO INFORMATION

Cargo will be ready for shipping on: (MM/DD/YYYY)

Cargo/Commodity Description:


                   Dimensions: Inches  or  Centimeters  (please specify)

 Item #  Type of Packaging/Unit   L  X  W  X  H       Weight: Lbs or Kgs

    1            

    2            

    3            

    4            

    5            

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Customs FOB Value (in USD):                   

Do you require any Marine Cargo Insurance Coverage?:  Yes   No

If "Yes", then how much? (in USD):   

Hazardous material shipment?:   Yes No

If "Yes", then proper/official HAZMAT Description:

  

Hazardous Class: 

UN Number: 

Any special handling needs/requirements?:

  

CARGO ORIGIN/DESTINATION INFORMATION

POL (Port of Loading/Origin Port): 

POD (Port of Discharge/Destination Port):             

Do you need any inland trucking or container drayage or intermodal services for your cargo at origin or destination?:  Yes  or  No

If "Yes", then please specify type of service needed: 

Origin of shipment:

Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal Code:
Country:

Destination of shipment:

Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal Code:
Country:

Special Note: Initially, at least City, State, and Zip/Postal Code info is needed for all door pick-ups and/or deliveries, regardless of whether inland service requested is for FCL container drayage or whether it is for LTL/FTL trucking!  All initial inland trucking rates that we offer for all door pick-ups and/or deliveries are based on the fact that such doors are both commercial locations and both also have a dock.  If otherwise, then you will be assessed and charged additional accessorial fees accordingly.  Please note that you must inform us at time of booking and prior to our final scheduled pick-up/delivery of cargo that any type special services are needed to be provided.  (Special services include, but are not limited to: Lift-gate services, Inside door delivery (usually only at ground level), etc.).

TYPE OF TRANSPORT SERVICES NEEDED

Mode of transport required:  

Type of Transport needed*:  

If ocean transport service needed, then type of ocean transport service required: 

* For DDU services, please specify who is to pay for import customs clearance charges and import duties/taxes, shipper or consignee?:

 

If ocean container service needed, then type of shipment:

FCL (Full Container Load)      LCL (Less than Container Load)

If FCL, then number of containers required: 

Container type required: 

If "Other" container type, then please specify:

If multiple types of containers are needed, then please specify:

Item #       No. of Containers                     Type of Containers

    1                                

    2                                

    3                                

    4                                

    5                                

Special Handling Instructions?:  

 

Additional Comments:  


 

 

Copyright � 1999-2010 CAPITOL SHIPPING AND LOGISTICS. All rights reserved.
Revised: 08/17/07.