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General Name Company Street Address City State Choose One... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip Phone Fax Email (required) Type of Product Is this product hazardous? No Yes Inventory How many different stocked line items? How is the product packaged? (ex. 50# bags on pallets) What is the average on-hand inventory? (specify units, pallets, or weight) Does your product stack when palletized and if so how high? No Yes, How High? What are the physical dimensions of your product on a pallet or individually (Length, Width, Height, Weight) Inbound What is your inbound shipping method? (FTL, LTL, 40-Container, 20-Container, Rail, etc.) Is your product palletized upon receipt or floor loaded? Palletized Floor Loaded How many inbound shipments per month? How many pallets or units on average receipt? How many different line items per receipt? Does your product have any special requirements upon receipt? No Yes Outbound What is your standard lead time? What percentage of orders are received in the afternoon for same-day shipment? What is your outbound shipping method? (FTL, LTL, 40-Container, 20-Container, Rail, etc.) How many pallets or units on average outbound order? How does your product ship out? Full Pallets Picking Required Combination Floor Loaded How many different line items per outbound? Does your product have any special requirements on outbound order? No Yes Other Do you require any special quality checks? No Yes Do you want Palmer to use your computer system? No Yes, Specify system Are you interested in transportation/drayage rates? No Yes Additional information required for quotation purposes.