Company Name:
Address:
City: State: Zip:
Contact Name:
Phone:

Company Name:
Address:
City: State: Zip:
Contact Name:
Phone:

Yes No

HAZMAT UN/NA number:
Class:
Packing Group:

*If HAZMAT, copy of B/L MUST be sent to Compass with shipment either by fax 630-243-0250 or email ahb@cpqs.com or klt@cpqs.com.

Company Name:
Address:
City: State: Zip:
Phone:
Contact Name:
Contact Email:

Special Instructions: