Powell Trucking, Inc.; Rate Request Form

RATE REQUEST

Electronic Submission for the Rate Request Form is Temporarily Unavailable.

Please click on one of the following forms that you may print and fax, or attach to an email for submission of your rate request. You may also fill in this form and then print it for fax or email.

Word/Rich Text Printable/Email Form Adobe PDF Printable Version

We apologize for the inconvenience and hope to have the online form functioning soon.

Complete the form below to request a rate quote for your load. All information is required in order to provide you with a valid quote. If you have questions about items included on this form, please contact our office for assistance.

CONTACT INFORMATION:

Name:

                 First Name                                                 Last Name

Company Name:

Billing Address:

                                      Street Address or PO Box Number



                                      City                                                         State                Zip Code

Phone:       xxx-xxx-xxxx

Fax:            xxx-xxx-xxxx

Email:                  Confirm Email:

LOAD INFORMATION:

Origin:

Destination:

Load Date:

Delivery Date:

Commodity:

Number of Pieces:

Value of Commodity:

Dimensions of Load:



Length                            Width                              Height                             Weight

Trailer Type Request:

Load Comments:

List any other service that you would like figured into this rate:

Rates provided by Powell Trucking, Inc. are for quote purposes only and do not constitute a contract for services. Please follow instructions received with your quote to continue the booking process. Your quote will be processed as quickly as possible, but please allow 24 hours for a reply. If you need immediate assistance, please call the business office at (409)579-2121

Your information will not be shared with any third parties nor will it be used for purposes other than providing you with a quote for this request and future business contact by Powell Trucking, Inc. By submission of this request, you agree to receive future information about services provided by Powell Trucking, Inc. but may at any time request to be removed from our mailing list by contacting the business office.

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