Horizon Tank Lines Rate Request

Horizon Tank Lines Rate Request Form: Date: #Form.Date# Company: #Form.Company# Name: #Form.Name# Street: #Form.Street# Suite: #Form.Suite# City: #Form.City# State: #Form.State# Zip: #Form.Zip# Email: #Form.Email# Phone: #Form.Phone# Fax: #Form.Fax# Product: #Form.Product# Origin: #Form.Origin# Destination: #Form.Destination# Referral: #Form.Referral# Equipment: #Form.Equipment# Comments: #Form.Comments# HTL Logo

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About Us | Rates | Driver Profiles | Links | Sales & Marketing

ICC No. 275157, USDOT No. 564280, SCAC HTLS, HAZMAT Certificate No. 062496009005E
Insurance of $5M single & $5M general with $100K of cargo.

Copyright © 1998
This document was created by Meredith Hilt merymouse@cadcol.com.
Last Modified 04/23/98.
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Horizon Tank Lines
Post Office Box 2857
Durham, North Carolina 27715-2857
919-286-7977 Fax: 919-286-7987
E-mail: charlescollie@horizontanklines.com

About Us | Rates | Driver Profiles | Links | Sales & Marketing

Thank you for your interest in Horizon Tank Lines. We would be very happy to provide you with information on our rates. Please fill out the form below and one of our representatives will contact you.

Date:

Company:

Street Address:

Suite or Apartment:

City:

State: Zip:

Contact Name:

Email:

Telephone:

Fax:

Product:

Origin:

Destination:

How did you
hear of us?

Equipment Requirements:

Comments or Questions:

Please only hit "Submit button" once!
Thank you!

ICC No. 275157, USDOT No. 564280, SCAC HTLS, HAZMAT Certificate No. 062496009005E
Insurance of $5M single & $5M general with $100K of cargo.

Date:
Company:
Street Address:
Suite or Apartment:
City:
State:	Zip:
Contact Name:
Email:
Telephone:
Fax:
Product:
Origin:
Destination:
How did you hear of us?
Equipment Requirements:
Comments or Questions:

	Please only hit "Submit button" once! Thank you!