UCSD Shipping Rate Quote Please fill out this form completely. Print and Fax to: Shipping Department, (858) 693-0864. Please Note: This is not a Shipping Memo; it is only a quote request. Shipper: _______________________________________________________ (Name) _______________________________________________________ (Email Address) _______________________________________________________ (Pick-Up Location – Building and Room Number) _________________ _____________________ ______________ (Phone) (Fax Number) (Today’s Date) Address and Postal Code Consignee: _______________________________________________________ (Name) _______________________________________________________ (Address) _________________ ________ ______________ ____________ (City) (State) (Zip Code) (Country) _____________________________________________________________________ (Other) General Description of Commodity Quantity of Pkg. Pkg. Type (Box, pallet…) Dimensions of each (in.) Weight (kg or lb) __________________________________ __________ ____________ ___________ _________ __________________________________ __________ ____________ ___________ _________ __________________________________ __________ ____________ ___________ _________ __________________________________ __________ ____________ ___________ _________ Does this shipment contain any hazardous material: _____________ If International shipment, will it be coming back to the United States: ___________ Preferred Mode of Transportation (Air, Ground, Ocean): ________________ Required Delivery Date: _____________ Value of Entire Shipment (U.S. Dollar): ______________ Comments/Special Instructions: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Questions? Please contact the Shipping Department, (858) 536-3225 x244 or bfsshipping@ucsd.edu.