Truck Type: Flatbed , Step Deck, RGN, Van, Reefer (Can circle more than one): ____________________________________________
Your Pickup #________________________
Full/Partial (circle 1) Load
Weight ________________Width_______ Length _____________
Origin: ________________________________________________
Address _______________________________________________________
City________________________ State______________
ZIP Code__________________
Pick up times/Date ___________________
Phone _____________________________
Contact Name _____________________________
Destination: Company Name:_________________________________________________
Address_____________________________________________________
City________________________ State__________________
Zip Code____________
Delivery times/Date __________________
Phone ________________________
Contact Name _______________________________
Email:____________________________ Fax_______________________
Special Instructions
__________________________________________________________
___________________________________________________________
Rate Confirmation _______________ Per ______________________
plus any permit.
Customer Signature ___________________________________________
Date ____________________
Fax: 206-666-4140*** (PLEASE COMPLETE ALL SECTIONS BEFORE RETURNING!
First Contact LLC Logistics Division
General Manager Al Bass
210-782-9055
First Contact, LLC, Phone 210-651-2045, Fax 206-666-4140
First Contact LLC is agent #120
For RRTS