Gallagher Transport International, Inc.

DENVER, COLORADO • PORTLAND, OREGON

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EXPORT QUOTE REQUEST

NOTE: If you do not wish to fill in the following information and would like a GTI representative to contact you then you can send us an e-mail by clicking below...

and a GTI representative will contact you ASAP.

Otherwise, please complete the remainder of this form.

*Required Fields
*Please select one: Air Quote Ocean Quote Both

Contact Information
*Your Name
*Company
*Address
*City		*State
*Postal Code		*Country
*Telephone	- -	*Fax	- -
*Email

Shipment Origin
	*City
	*State
	*Country
	Postal Code	(Required for Door Service)
Shipment Destination
	*City
	*State
	*Country
	Postal Code	(Required for Door Service)
Shipment Details
	*Commodity

ss*Is this shipment Hazardous/Dangerous?	Yes	No
If Yes: UN#	Class#

Harmonized code(s), if known:
Special instructions:

How much cargo would you like to ship?
	*Total # of		*Package/Container	*
	Packages		type
	Weight per		*Total shipment		*
	Package		weight
	*Dimensions	and/or Enter Dimensions below:
	Cubic

*Pieces		*Length	*Width	*Height




	Please specify UNIT* of measurement used:

Type of Shipment
	*AIR*
	Service Level	IATA Direct (Next Avail. Flight)
		Standard Consolidation (3-5 Days)
		Deferred Consolidation (5-7 Days)
		Other
	Service Scope

	OCEAN
		Shipment Type?	LCL (Loose Packages)	FCL (Full Container)

		Is special equipment needed?	Yes	No
		If yes, what type of equipment?
		If you have special routing preferences, please indicate:

Shipment Time Frame
	*When will cargo be ready for shipment?	Date	Month	Year

Terms of Shipment
		Will Be Paid By
	The costs for	You	Others	GTI to Quote
	Air Freight
	Position empty container (if FCL) at origin
	Inland freight to terminal (export)
	Documentation/Handling fees (export)
	Origin terminal charges
	Ocean freight to destination port/terminal
	Destination Customs clearance handling
	Destination terminal charges
	Destination Customs duty and taxes
	Inland delivery to consignee door
	Inland trucker's chassis repositioning
	Incoterms of sale (if known)

SPECIAL: Would you also like a quote on Cargo Insurance?

YES, I would also like a quote for Cargo Insurance.

No, I would not like a quote for Cargo Insurance.

If Yes, Please provide a value for your shipment: US $

Coverage Scope: Door to Door Door to Port Port to Port Port to Door

(Response will be within 24 to 48 hours unless further details are required upon which we will contact you for further details.)

By submitting the above details, I hereby give permission to Gallagher Transportation Intl.,Inc. Export Department to respond to the email and/or telephone me, as provided above.

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