Unishippers Vendor Shipment

FREIGHT BOOKING REQUEST

Company Name*

Account Number*

Your Email*

Your Phone#*

ORIGIN

Origin Company Name*

Origin Address (line 1)*

Origin Address (line 2)

Origin City*

Origin State*

Origin Zip*

Origin Country*

Origin Contact Name*

Origin Contact Phone*

Origin Contact Email

DESTINATION

Destination Company Name*

Destination Address (line 1)*

Destination Address (line 2)

Destination City*

Dest. State*

Dest. Zip*

Dest. Country*

Destination Contact Name*

Destination Contact Phone

Destination Contact Email

SHIPMENT INFORMATION

Please note: Carriers require a two-hour span of time between ready and close times. Shipments scheduled for same-day pickup after 3 PM may be automatically pushed to the next business day.

Ready Date*

Date

Value of shipment*

Broker Company or Name

Broker Contact

Broker Phone

Reference Number

Other Origin Service

Other Destination Service

Notes/Additional References

HANDLING UNIT / ITEM DETAILS

Handling Units

# of Units*

Type*

Stackable*

Unit Length*

Unit Width*

Unit Height*

Items

Piece Count

Piece Type

Total Weight*

Class*

NMFC

Hazmat?*

Proper Shipping Name

UN

UN #

PKG

Hazmat Class

Contact Name/Phone

Commodity Description*

Maximum of 20 Items

Maximum of 20 Handling Units