Please complete the fields below and we will respond by next business day with your quote! (Please provide DIMs in inches for all pieces).

Request For Quote
Company Name*
Your Name*
Phone*
xxx-xxx-xxxx
Extension #
FAX*
Email*
State*
Zip Code*
Shipment Information
Origin City*
Origin State*	IA IL KS KY MO NE OH OK
Origin Zip Code*
Destination City*
Destination State*	IA IL KS KY MO NE OH OK
Destination Zip Code*
Total Pieces*
Total Weight (Pounds)*
Dimensions*
Accessorial Charges (check all that apply)	Liftgate Delivery Liftgate Pickup Pallet Jack 2 Person Pickup/Delivery Residential Delivery Residential Pickup Inside Delivery Inside Pickup Military/Government Facility/School Authorize Wait Time Special Pickup/Delivery (limited hours or special availabilty
No Convention Center pickups or deliveries. Contact your local cartage agent!
C.O.D. $
Excess Value $
Contact Midwest Express Co. if over $50,000.00
Hazardous Material*	Yes NO
Hazmat Class	2.1 Flammable Gas 2.2 Non-Flammable Gas 2.3 Toxic Gas 3 Flammable Liquid 4.1 Flammable Solid 4.2 Spontaneous Combustion 4.3 Dangerous when wet 5.1 Oxidizing Material 5.2 Organic Peroxides 6.1 Toxic 6.2 Infectious Substance 7 Radioactive 8 Corrosive Multiple Classes
Midwest Express will NOT Accept the Following Hazmat:
Division 1.1 - 1.2 - 1.3 - 1.4 - 1.5 - 1.6
Division 2.3, Hazard Zone A
Division 6.1, PG1, Hazard Zone A
Highway Route Controlled quantities of a Class 7 as defined in 49 CFR 173.403
Note / Comments
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