Carrier Profile
Please fill the form below accurately to enable us serve you better... Welcome!
Carrier (Company) Name
*
Name
Owner Name
*
First Name
Last Name
Driver Name (If different)
First Name
Last Name
Complete Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone:
*
E-mail:
*
Are you:
Owner Operator (own authority)
Owner Operator (Leased)
Fleet Owner (multiple trucks)
Do you have:
Class A
Class B
Class C
HazMat
Doubles
Triples
TWIC
EIN#
*
USDOT#
*
MC#
Please send a copy of your CDL (for each driver), signed W-9, Proof of insurance, and copy of authority
*
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Equipment Info
Equipment Types
*
Flatbed
Dry Van
Reefer
Sprinter van
Box Truck
Other
Do you have the following:
*
Lift Gate
Dock High
Pallet Jack
Straps
Load Bars
ELD
GPS App
Fuel Cards
Other
Dimensions and max weight of equipment selected
*
Small Fleets
Only
Tractor Info
Make/Model
Year
Truck#
Tractor #1
Tractor #2
Tractor #3
Trailer Info
Year
Trailer #
Air Ride
Vented
Plated
E-Tracks
# of Straps
Load Bars
Wood Walls
Swing Doors
Trailer #1
Trailer #2
Trailer #3
Driver Info
Telephone
Truck #
Trailer #
Hazmat
Tankers
TWIC
Driver Name
Driver Name
Driver Name
Load Info
Min. Miles Per load
*
Max Miles Per load
*
Max DH Miles
*
Minimum Rate per Mile
*
Regions/States you prefer to run
*
Regions/States you prefer not to run
*
How many days on at a time/specific days off
*
How did you hear about us?
Comments/Special Instructions
Signature
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