UPX On-Line Pick Up Request The fields marked with (*) are required fields. * Please enter a Service Level: Customized Service, Next Day, 2 Day, Economy (3-5 Day), Int'l Export  * required   Enter all Accessorial Services Required such as Liftgate, Inside, Pallet Jack, Time Specific, Extra Man, Blanket Wrap, Air Ride, Crating/Un-Crating, Debris Removal, COD, Convention/Hotel, Residential, etc... * Ready Time  * required * Close Time  * required * Number of Pieces  * required * Total Weight  * required   Enter Dimensions LxWxH * Hazardous Materials ? Yes No * Do You Want To Insure This Shipment ? Yes No * What is the Declared Value Amt to Insure ?  * required * Shipper  * required * Address Line 1  * required   Address Line 2 * City, State, Zip  * required * Contact Name  * required * Telephone Number  * required   Email Address * Consignee  * required   Address Line 1   Address Line 2   Contact Name * City, State  * required * Destination Zip Code  * required   Telephone Number   Your Comments

Delivery Options: -Same Day -Overnight -2-Day -3-5 Day

Services Available: -Air Dry Equip Trucks -Warehousing -Hot Shots -Blanket Wrap -Inside Deliveries -2-Man Delvery -Packing & Crating -Uncrating & Set-up -Debris Removal -Minor Installation