Carrier Onboarding Form

Carrier Onboarding Form
Company Info:
Company Legal Name:*
MC #:*
DOT #:*
SCAC:
Enter your SCAC if you have one, leave blank if you do not.
Company Primary Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Phone:*
Please enter a valid phone number.
Company Fax:
Please enter a valid phone number.
Company Email:*
example@example.com
Do you use factoring?*
If you answer "YES" to factoring please provide Remit to Name:
If you answer "YES" to factoring please provide NOA:

Cancelof
Remit to Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EIN*
W9*

Cancelof
Liability Insurance Provider:*
Liability Insurance Policy Number:*
Liability Coverage Amount:*
Liability Insurance Start Date:*

MonthDayYear
Date
Liability Insurance End Date:*

MonthDayYear
Date
Cargo Insurance Provider:*
Cargo Insurance Policy Number:*
Cargo Coverage Amount:*
Cargo Coverage Start Date:*

MonthDayYear
Date
Cargo Coverage End Date:*

MonthDayYear
Date
Certificate of Insurance (COI):*

Upload COI for info and instruct Agent to email dispatch@bestpropertysolutions.net a COI listing us as Cert Holder: BEST Property Solutions Inc, 4416 S Co Rd 325 E, Logansport, IN 46947
Cancelof
Equipment Avail:

Bumper Pull (BP)Fifth Wheel (FW)Gooseneck (GN)PintleMulti-Haul (Center Rail + Winch)Auto Hauler

Accounting Setup for ACH Payments
I (we) First Name* Last Name* hereby authorize BEST Propety Solutions Inc herinafter called COMPANY, to initiate credit and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my (our) checking account indicated below, hereinafter called DEPOSITORY, to credit and/or debit the same to such account.
Depository Name:*
Named Account Holder (i.e. Company Name) should be entered here.
Routing Number:*
Account Number:*
Voided Check*

Please upload a voided check or letter from financial institution that confirms the routing and account number submitted.
Cancelof
Signature*

Clear

Company Info: