Reporting Premium Freight

Instructions: You can complete this form online.
Or, you can print out the PDF file, complete it and mail or fax that to QSR, attention: Purchasing.

Vendor:		Blank, printable form.
Address:

1	Any premium freight charges paid by your company last quarter for QSR's deliveries? (Premium freight charges are any extra charges added to normal delivery charges to ensure delivery)		Yes No
2	If Yes, what was the total premium freight charge?
3	If Yes, Please list Date, Reason and QSR PO Number:
	Date	Reason	QSR PO#
4	Form completed by:
	Email Address:
	Title:
5	Send form to Purchasing:

If you have any technical problems submitting this form contact Steve Schlosnagle at QSR.