Contact Name
Company Name
Address 1
Address 2
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Phone		Fax
E-Mail

Tell us about your company:

How is the product to be received?	How does the product arrive?
Palletized Floor Loaded Slip Sheeted Other	Truckload Container LTL Carrier Other

How many SKU's or Product Codes?
How many Units per pallet (on average)?

Item		Units per pallet
Item		Units per pallet

How many pallets (or units) per truckload, inbound?

Pallets Units

Is the product stored on pallets?

Yes No

How can the pallet be stored?

Bulk Stacked On Racks

Check all of the special conditions that apply to your product.

Temperature Haz-Mat Food Grade Other Other

How is the product picked?	How is the product shipped?
Pallet Case Piece Other	Pallet Case Piece Other

How is the outbound freight to be carried?

Truckload Container LTL Parcel Carrier

How many units on outbound load (on average)?

Pallets Cases

Please provide any other pertinent information: