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Rate Request Form
Contact Information:
First Name:
Last Name:
Company:
Your Company Reference:
Company Address:
Company Address (cont):
City:
State:
Zip Code:
Country:
Work Phone:
Work Fax:
E-mail:
Company Website Address:
Shipment Details
Mode of Shipment:
SELECT HERE
Ocean Freight - Full Container
Ocean Freight - Less Than Full Container
Airfreight
Uncontainerizable Cargo
Origin of Shipment:
Port of Loading:
(if not point of origin)
Port of Discharge:
Final Destination:
(if not port of discharge)
Desired Shipping Date:
January
February
March
April
May
June
July
August
September
October
November
December
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Commodity:
Harmonized Code (if available):
Value of Shipment
Method of Transportation: Break Bulk
Total Number of Pieces:
Type of Package:
SELECT HERE
Carton
Crate
Pallet
Skid
Other
Total Gross Weight:
lbs
kgs
Specifications:
Please enter dimensions for each piece.
(LENGTH X WIDE X HEIGHT (inches or cm)
WEIGHT (lbs or kg).
Example: 25 x 18 x 84 inches - 7,800 lbs.
Example: 720 x 205 x 450 cm - 43,679 kgs)
Method of Transportation: Containerized Cargo
Total Number of Containers:
Specify quantity for each container type:
20 ft standard
40 ft standard
45 ft standard
20 ft open top
40 ft open top
45 ft high cube
20 ft flat rack
40 ft flat rack
20 ft reefer
40 ft hi cube
40 ft reefer
Terms of Shipment:
ExWorks
FAS
FOB
CFR
CIF
Prepaid or Collect?
Prepaid
Collect
Terms of Payment?
Open Account
Sight Draft
Letter of Credit
If Letter of Credit do we prepare ?
Yes
No
Do you require insurance ?
Yes
No
Is shipment subject to HAZMAT ?
Yes
No
Special Instructions:
Please enter text in photo to Submit:
Please click the 'Submit Form' button only once & wait for the 'Confirmation' Page to appear.
(This may take several seconds)
Samuel Shapiro welcomes the opportunity to bid on your freight.
We will get back to you as soon as possible.
