Company Name:

Address:

Phone:               Fax:

Contact and Title:

General Account Information

Service Area:       

Commodity Type:

Number of Total Items (SKU):

Average # of Cases / Pallet:     Average Case Weight:

Average # of Pallets on Hand :

Special Temperature Requirements : Yes   No             Hazardous Materials:  Yes   No

Inbound/Outbound Information

Average units per Inbound:     Average SKU's per Inbound

Average Inbounds per week or month:

Freight Classification: 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 or higher

Average Orders Outbound per Day:    Average Cases per Order:

Additional Information

Projected Start-up Date:

Length of Contract to Consider

Please list any additional business requirements that were not listed above.