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CONTACT DETAILS

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Company Name

Contact Name

Contact Number

Email

PICKUP DETAILS

Pickup Date

Location Services:

Power lift gate required (dock loading not available)

Straight truck only (can not accommodate 53' trailers)

This is a residential address

This is a trade show

Pickup Address

Additional Pickup Details

@rileycoopergroup.com

DELIVERY DETAILS

Delivery Date

Location Services:

Power lift gate required (dock loading not available)

Straight truck only (can not accommodate 53' trailers)

This is a residential address

This is a trade show

Delivery Address

Additional Delivery Details

SHIPMENT DETAILS

Select a Service Type

LTL Shipment

Type

Quantity

Length

Width

Height

Measurement

Total Weight

Can Be Stacked

Hazardous

Temperature Control Required

FDA (Food & Drug Administration)

Commodity

Detailed Notes About This Shipment

FLAT DECK SHIPMENT

Total Weight

Equipment Type

Commodity

Extras:

Strapping Required

Tarping Required

Escort Required

DRY VAN TRUCKLOAD SHIPMENT

Total Weight

Ft of Trailer req.

Commodity

Extras:

Floor Load

Temperature Control Required

Hazardous

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