Commodity Description
Import / Export
Cargo Weight in LBS
Over-Dimensional Cargo?
If yes, please give dimensions and brief description.
Size Container
Hazardous YES / NO
If YES, Class and UN number is:
Type of Container
Please tell us how you heard about us.
Steamship Line
Point of Origin
Destination (city/state)
Round trip / One way
           Choose 
LIVE LOAD / UNLOAD or     DROP / PICK
Number of hours to load / unload
Approximate date of Shipment:
Thank you for the opportunity!
* Indicates REQUIRED field
MO/DAY/YEAR
Additional Comments.....
# of Loads:
*  Company Name
*  Street Address
*  City, State, Zip
*  Telephone #
*  Fax #
*  First & Last Name
*  E-mail Address
U.S. INTERMODAL CORP.

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