READING BLUE MOUNTAIN AND NORTHERN RAILROAD COMPANY

P.O. Box 218 Port Clinton, PA 19549

Telephone 610-562-2100 Fax 610-562-1921 Coal Fax 610-562-0596

RETURN COMPLETED FORM VIA FAX

POTENTIAL CUSTOMER QUESTIONNAIRE

This form is designed to help us get a rate for you as soon as possible. In order for us to do this, we need you to fill out this Questionnaire COMPLETELY. If it is not filled out completely we cannot possibly get you a rate. All information is necessary to get a competitive rate. If you have any question, or do not have all the needed information, please contact us. Thank you for giving us the opportunity to help you with your transportation needs.

Date: ______________________________

Shipper Contact: ________________________________

Shipper: ____________________________ Telephone Number: (_____) _________________

Address: ______________________________ Origin Station: ___________________________

_______________________________ Origin Phone: (_____)_____________________

Origin Contact:_________________________ Origin Railroad: ________________________

Receiver: _____________________________ Receiver Contact: _______________________

Address: ______________________________ Telephone Number: (_____) ________________

______________________________

Destination Station: ______________________ Destination Railroad: ______________________

Commodity: ____________________________ STCC No.: ______________________________

Type of Car: ____________________________ Weight Requirements: _____________________

Approximate number of cars per year: _________ Shipments would begin: ___________________

Truck rate (optional): _____________________ Rate needed to compete: ___________________

Routing: _______________________________ Prepaid or Collect (circle one)

Inbound or Outbound (circle one) Special Requirements: _______________________

Does car need to be weighed? YES NO (circle one)

Do you have a rail siding or spur? YES NO (circle one) If No; where do you plan to access rail cars? ________________________________

Person completing form: _____________________ Your Company: __________________________

Telephone number: (____) __________________ Fax Number: ( _____) ____________

RAILROAD OFFICE USE ONLY:

Information received by: _____________________ Date: ____________________

Information handed off to: ___________________ Date: ____________________

NS contact: ______________ Telephone ( ____) __________ Fax #: (_____) ________________ E-Mail: _______________________

RATE INFORMATION:

RBMN Division: ____________________________

RR # 1__________________________ RR # 2 __________________________

Per car division___________________ Per car division ________________

Weight _______________________ Weight __________________

RATE: __________________ RATE: _________________

TOTAL THRU RATE $ _______________________

Sign off: ____________________________

Date: ______________________________

NOTES: