Rate Request

From (Origin)		To (Destination)

Will this move be :

Prepaid

Collect

Shipper Name:

Street Address: City:

Province: Alberta British Columbia Manitoba Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Saskatchewan Yukon Territories

Postal Code:

Contact Name: Phone: Fax:

Email:

Do you want the rate reply to be sent to you:

personally by phone

Via Fax

Email

Would you like our Sales Department to contact you?

Yes

No

Is the pick up location different from the Shippers address? If so, please provide the following information:

Origin Name:

Street Address:

City: Province: Alberta British Columbia Manitoba Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Saskatchewan Yukon Territories

Postal Code:

Contact Name: Phone:

Package/ Unit Type

Envelope - (Indicate number of units on average. )

Box - (Indicate number of units on average. )

Pallet - (Indicate number of units on average. )

Trailer load - (Indicate number of units on average. )

Weight: (Units lbs. kg ) Commodity:

If this is more than one time move, please check frequency of shipment:

Daily

On Request