Logistics Services - Transportation Request

Note: One form must be completed for each request. All requests must be placed between 7:00am and 2:45pm Monday to Friday.

Company / Customer Name*

Contact Name*

Customer Address*

Customer Telephone Contact (123-4567)*

Contact E-Mail Address*

Consignee Name (If different from above)

Type of Haulage service Required*

Container Number*

Container / Trailer Size*

Cargo Type / Container Size*

Cargo Description

Please indicate Pickup Date

If container has to return to Port, please indicate return date

Additional Remarks

Name and Designation of Requester*