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Back   Help SHIPPER Name: Address 1: Address 2: Country: United States Canada Mexico Zip/ST:     City: Choose City Phone: CONSIGNEE Name: Address 1: Address 2: Country: United States Canada Mexico Zip/ST:     City: Choose City Phone: BILL TO Name: Address 1: Address 2: Country: United States Canada Mexico Zip/ST:     City: Choose City Phone: REMITTANCE Name: Address 1: Address 2: Zip/ST:     City: Choose City       OTHER INFORMATION BOL#: PO#: Freight Charges: PPD Collect Must Deliver On or Before: COD Funds: Collect CCA Cust. Check CCR Cash/Certified Funds COD Fee: PPD Collect COD Amt (US$): COD Disclaimer: Averitt is not liable for collection of COD shipments that are not properly entered into this electronic system.  Further, Shipper agrees to indemnify Averitt for the costs of collection, including attorney's fees and costs, in the event that Shipper fails to properly enter COD information into this system.   STANDARD LTL GUARANTEE SHIPPING OPTION This option will guarantee delivery by 5:00 P.M. according to published LTL service standards, and applying only within carrier´s direct service area. Shipment must be available for pickup by 5 P.M. Cost of Standard LTL Guarantee is 25 percent of discounted freight charges with a minimum of a $ 30 charge. Standard LTL Guarantee Shipping Option   ACCESSORIALS Arrival Notify   Convention Center Delivery Inside Delivery   Construction Site Delivery Liftgate   Residential Delivery Non-Commerical Pickup/Delivery     ITEMS TO SHIP No. Unit & Type Description NMFC - Sub Class Weight (lb) Hazardous Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    Skids/Pallets Drums Cartons/Boxes Pieces/Other Select Description: Other (Input Manually) - 50 55 60 65 70 77.5 85 92.5 100 110 125 150 175 200 250 300 400 500 Yes *** Hazardous Material Description *** UN#     PkgClass     HazClass     Desc.   UN#  Select Description   N.O.S. Description    + Add 5 More Items Additional Shipping Information (140 characters limit):   To view account specific information, please log onto My Averitt Express