Freight Broker Load Confirmation Sheet
Broker & Shipper Information
Broker Name
Broker Phone
Broker Email
Shipper Name
Shipper Phone
Shipper Address
Carrier Information
Carrier Name
Carrier MC#
Carrier Phone
Driver Name
Load Details
Load Number
Equipment Type
Commodity
Total Weight
Pickup Information
Pickup Date
Pickup Time
Pickup Location
Pickup Number
Delivery Information
Delivery Date
Delivery Time
Delivery Location
Financials
Line Haul Rate
Fuel Surcharge
Total Pay
Special Instructions / Notes
Carrier Acknowledgement
Carrier Signature
Date