Order Form

To submit a requested order to CPx, please complete the form below. Once your order is entered into the system, we will advise you of the order number and confirm equipment availability prior to booking pick-up of the freight.

If the information is not applicable to your order please input N/A.

Bill To Info.

Company Name Address City Province/State Postal/Zip Code

Contact Name Phone Email*

Shipper Info.

Same as Bill To Info. (if checked skip this section)

Company Name Address City Province/State Postal/Zip Code

Contact Name Phone Email

Consignee Info.

Company Name Address City Province/State Postal/Zip Code

Contact Name Phone Email*

Shipment Details

Requested Pick-up Date & Time (please use 24 hour clock) Requested Delivery Date & Time (please use 24 hour clock) Commodity Total Pieces Total Pallets Total Weight (lbs or kgs)

Temperature (F or C) Declared Value Broker (if applicable) PO# Trace Numbers