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Rail Billing Form

Company Name:     ______________________________

Address:          ______________________________

               ______________________________

               ______________________________

Sender:          ______________________________

Phone:               ______________________________

Fax:               ______________________________

Container Number:     ______________________________

Rail origin:          ______________________________

Rail destination:     ______________________________

Size:               ______________________________

Seal:               ______________________________

Weight:          ______________________________

Contents/STTC:     ______________________________

Hazardous          ______________________________

Route:               ______________________________

Notify Party:          ______________________________

Notify Contact:           ______________________________

Rate/Quote #          ______________________________