:: GRUPO TECNAPO :: Mol

:: general agents

:: mol

:: mol logistics

:: barwil unitor ships service

:: sailing schedules

1. Select the company:
Company:*
2. Company Information
Please Select one of the choices :

A. LOCAL COMPANY:

Name of Company: *

Taxpayer Number :*

B. FOREIGN COMPANY:

Name of Company: *

C. INDIVIDUAL PERSON:

Name: *

ID Number:*

Mandatory Information :

Name of person in contact: *

Email: *

Tel.: *

Fax: *

3. Parties to the Transaction

Mode of Transportation:*

4. LCL Commodity Information *

Pcs.:

Wgt.:

Msr.:

Commodity:

5. FCL Equipment Information *

Equipment Type:

Number of Units:*

Other:

Equipment Type:

Number of Units:*

Other:

Equipment Type:

Number of Units:*

Other:

6. Hazardous Cargo Information

Hazardous Cargo?: *

Yes No

No Hazardour cargo?, go to section 7.

Name of Product:

Hazardous Class:

Hazardous Page:

Hazardous U.N. Number:

Hazardous Comments/Description:

7. Origin/Destination *

Freight originating in (City/Port): *

Freight originating in (State): *

Freight originating in (Zip Code): *

Freight originating in (Country) :*

Destination (Country, City): *

Other

8. Spotting Information

Spotting Required:

If spotting is not required, please skip section.

Spotting Location:

Spotting Date:

Spotting Time:

Hours of Operation:

P.O./Reference Number:

Loading Type:

9. Prepaid/Collect Information *

Prepaid/Collect: *

10. Comments/Remarks

Comments/Special Remarks:

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