Shipper Details

Your Reference Number

Company Name *

Agents Name *

Your Shippers First Name *

Your Shippers Last Name *

Your Shippers USA Address (For AES Filing)

ID Type:(Social Security Numbers will not be accepted)

Service Type * -- Select -- Port to door Port to port

Drop Off Location * -- Select -- Los Angeles New York

Estimated Drop Off Date Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 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 2016 2017 2018 2019 2020

Shipment Details

Volume in Cubic Feet

Number of Items being Delivered Crates or Loose

Marine Insurance (Suggested For All Shipments)

Marine Insurance & Shipment Value (VALUE MUST BE ENTERED FOR ALL SHIPMENTS) Yes No $

Total Loss" Marine Insurance Coverage is available at 1.85% of declared value with $0.00 Deductible. Coverage Includes- FIRE-THEFT-TOTAL LOSS coverage only.

I agree to the Terms of the Marine Insurance policy (click here) *

Consignee Details

Consignee First Name *

Consignee Last Name *

Consignee Destination Address *

Destination Port * -- Select -- Antwerp, Belgium Auckland, New Zealand Barcelona, Spain Bremerhaven, Germany Copenhagen, Denmark Gothenburg, Sweden Melbourne, Australia Oslo, Norway Rotterdam, Netherlands Sydney, Australia Thamesport, UK

Consignee Phone *

Consignee Email *

SERVICE RATE PER CUBIC FEET *

Comments and Special instructions

Agent Billing Details

Billing Name and Address *

Contact Phone *

Contact Fax *

Contact Email *