OPTIMOVE FREIGHT & LOGISTICS CARRIER PROFILE AND ONBOARDING FORM

CARRIER INTAKE/ONBOARDING FORM

Welcome to OptiMove Freight & Logistics LLC
Instructions: Please complete this form giving us all the information that pertains to you and your company. The better informed we are, the better we will be able to assist you. This form should be updated at any time by notifying us. This information is for our use only and will not be released to any third party without your express written permission.
PART 1: CARRIER GENERAL INFORMATION
CARRIER COMPANY NAME:
DBA (If Any)
Address

PHYSICAL ADDRESS

Street Address Line 2

CITYSTATE

ZIP
Address

MAILING ADDRESS

Street Address Line 2

CITYSTATE

ZIP
MAIN CONTACT PERSON:

First NameLast Name
IS THERE A NICKNAME YOU GO BY ON THE ROAD:
RoadKing, Pops, Top Dog, Big Boss - Anything goes!
CARRIER E-MAIL ADDRESS:
example@example.com
CARRIER PHONE NUMBER:
Format: (000) 000-0000.
FAX:
CARRIER CELL PHONE (WHATSAPP) NUMBER:
Format: (000) 000-0000.
EMERGENCY CONTACT PERSON:
EMERGENCY PHONE:
Format: (000) 000-0000.
YEARS ACTIVE:
HOW LONG HAVE YOU HAD AN ACTIVE MC #?
MC NUMBER:
DOT NUMBER:
ARE YOUR MVR & SUBSTANCE ABUSE HISTORIES CLEAN?
PART 2: EQUIPMENT TYPES
WHAT EQUIPMENT DO YOU USUALLY RUN (Please select all that apply):

Other
HOW MANY OF EACH EQUIPMENT TYPES DO YOU HAVE?
IS/ARE YOUR TRUCK(S) DOCK HEIGHT?
WHAT TRAILER ACCESSORIES DO YOU HAVE?
E TRACKS, STRAPS, TARPS, ETC.
WHAT IS YOUR ELD (Electronic Logging Device) PROVIDER NAME?
PLEASE LIST THE BROKERS THAT YOU ARE ALREADY SET UP/APPROVED WITH:
WHAT FACTORING COMPANIES ARE YOUR ENROLLED WITH (IF APPLICABLE):
PART 3: DISPATCH SPECIFICATIONS:

Tell us about your goals so we can better work for you!
Please give us your minimum cents per mile objective. We understand that many factors will change this information, but this will give us a starting point to better negotiate on your behalf. Thank you
DATE AVAILABLE TO GET ON THE ROAD

MonthDayYear
Date
HOW FAR DO YOU WANT TO DRIVE EVERY WEEK?
YOUR PREFERRED ZONES – PLEASE SELECT ALL THAT APPLY
CENTS ($) PER MILE
HOW MUCH ARE YOU CURRENTLY MAKING EVERY WEEK (GROSS)?
WHAT IS YOUR WEEKLY INCOME/REVENUE GOAL PER TRUCK (GROSS)?
$ 5,000 +
MAX # OF DELIVERIES PER LOAD
1 AND 1, MULTI-STOP, ETC.
DRIVER TOUCH (Y/N)
MOUNTAINS? (Y/N)
TOLLS? (Y/N)
WEIGHT LIMIT THAT YOU WANT TO/CAN SCALE UP TO:
HOME TIME- WHAT IS YOUR PREFERENCE?
ENDORSEMENTS (Y/N):
TYPE OF ENDORSEMENTS:
CLEARANCE TYPE: (TWIC, DBID, RAPID GATE, STA)
PLEASE TELL US WHAT ELSE YOU FEEL MAY BE IMPORTANT FOR US TO KNOW:
PLEASE UPLOAD YOUR FMCSA MC AUTHORITY LETTER:

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PLEASE UPLOAD YOUR CERTIFICATE OF INSURANCE:

(We require $100,000 in Cargo and $1,000,000 in Liability)
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PLEASE UPLOAD THE FRONT PICTURE/COPY OF YOUR DRIVER'S LICENSE:

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PLEASE UPLOAD THE BACK PICTURE/COPY OF YOUR DRIVER'S LICENSE:

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PLEASE UPLOAD YOUR SIGNED W-9 FORM

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PLEASE UPLOAD YOUR NOTICE OF ASSIGNMENT FROM YOUR FACTORING COMPANY (IF APPLICABLE)

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NOTE: When returning the Dispatcher Packet, PLEASE MAKE SURE TO INCLUDE THE FOLLOWING:

1) SIGNED Dispatcher Agreement

2) Carrier Intake/Onboarding Profile and Preference Form

3) Limited Power of Attorney (SIGNED AND NOTARIZED)

4) A copy of your MC Authority Letter

5) A copy of your Certificate of Insurance (COI)

6) A copy of your Driver's License (Front and Back)

7) Your completed and signed W-9

8) Your notice of assignment if affiliated with a Factoring Company

WELCOME TO OFL!

Thank you!
Signature
Please verify that you are human
OPTIMOVE FREIGHT & LOGISTICS LLC

5900 Balcones Drive, Suite 14896- Austin, TX 78731

PHONE (201) 307-4777
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CARRIER INTAKE/ONBOARDING FORM

PART 1: CARRIER GENERAL INFORMATION

YEARS ACTIVE:

PART 2: EQUIPMENT TYPES

PART 3: DISPATCH SPECIFICATIONS: