RATE REQUEST
Complete the form below and click the "submit" button 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 at (409)579-2121.
You may also print a copy of this form and fax to 409-579-2626, or email to rates@powelltrucking.com.
Click Here for Printable Form
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:
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: Select Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 2010 2011 2012 2013 2014 Delivery Date: Select Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 2010 2011 2012 2013 2014 Commodity: Number of Pieces: Value of Commodity: Dimensions of Load: Length Width Height Weight Trailer Type Request: Select One Of The Following: 53 FT VAN FLAT STEPDECK RGN/DOUBLE DROP UNKNOWN MULTI AXLE Load Comments: List any other service that you would like figured into this rate:
Origin:
Destination:
Load Date: Select Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 2010 2011 2012 2013 2014
Delivery Date: Select Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 2010 2011 2012 2013 2014
Commodity:
Number of Pieces:
Value of Commodity:
Dimensions of Load:
Length Width Height Weight
Length
Width
Height
Weight
Trailer Type Request: Select One Of The Following: 53 FT VAN FLAT STEPDECK RGN/DOUBLE DROP UNKNOWN MULTI AXLE
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.
Copyright © 2008 Powell Trucking, Inc.
Website Design and Maintenance by Off The Hook Marketing Solutions