Rate Quote – The Werking Group

First Name*
Last Name*
Company
Phone*
Email*
Type of Service Required*
Origin:
Pick Up Date*
MM slash DD slash YYYY
Pick Up Time*

: Hours

Minutes
Location of Pick Up*
City

Ontario addresses only.
Description of Shipment*
Length ( in feet)*
Width (in feet)*
Height (in feet)*
Weight (in pounds)*
Delivery
Delivery Date*
MM slash DD slash YYYY
Delivery Time*

: Hours

Minutes
Delivery Address*
City

Ontario addresses only.
Delivery Address is a*
- Business
- Residence
Loading Dock at Delivery Address*
- Yes
- No
Additional Information/Comments