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
Volume in Cubic Feet
Number of Items being Delivered Crates or Loose
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 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
Billing Name and Address *
Contact Phone *
Contact Fax *
Contact Email *
I agree to the Terms and Conditions *Click here to View Terms and Conditions
Verification Number *
Enter Verification Number Above *
