REQUEST
FORM
PERSONEL INFORMATIONS
Name Surname
:
Name of Company
:
E-mail
:
Phone
:
Fax
:
LOAD INFORMATION
Loading Port
:
Unloading Port
:
Loading Date
:
Delivery Date
:
Type of Cargo / Name of the Product
:
Number of Pieces
:
Type of Packaging
:
Gross weight (kilogramme)
:
Dimensions (cm)
Width :
Length :
Height :
Payment Conditions
:
Select
CIF
FOB
EXW
DDU
DDP
Type of Transport
:
Sea Transport
Air Transport
Road Transport
Pick Up Address of Load (please include the post code)
:
Delivery Address of Load (please include the post code)
:
Characteristics of the Packaging (wooden etc)
:
Select
Wooden
Metal
Plastics
Cartoon
Other
Type of Product
:
General Load
Perishable
Breakable
Live Animal
Dangerous Goods
Parts
Regular Delivery? (yes/no)
:
Select
Yes
No
Type of Loading
:
Select
FCL (complete)
LCL (partial)
BULK (bulk)
Delivery on Pallets? (yes/no)
:
Select
Yes
No
Copyright © 2007
Cosmo Lojistik
