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Company: ______________________________________

Contact: ______________________________________

Telephone: ______________________________________

City/State/Zip: _____________________________________

Origin ZIP: ________________________________

Destination ZIP: ________________________________

Total Load Weight: ________________________________

Commodity Description: _____________NMFC#:____________

Number of Pallets: ________ Stackable? ______________

Dimensions (LTL Only) L:______ W: ______ H: ______ (inches)

Freight Class (LTL Only): ________________________________

Pick-Up Time and Date: ________________________________

Delivery Desired By Date: ________________________________

Haz-Mat Class (If Hazardous): ________________________________

Assessorials (Liftgate/Tarp/Etc): ________________________________

Cargo Insurance Needs (If Any): ________________________________

Hi – This is from Air Ground Ocean.

We’re a freight broker eager for your business!

What types of products do you ship? _____________________

How often? _________________________? LTL or TL? ___________________

Dry van or flatbed? __________________________

What are your major lanes? __________________

Take me through your process to move loads? __________________________