Questionnaire

Questionnaire

Owner Operator/Carriers
Company Name*
Name*

PrefixFirst NameLast Name
DBA (Doing Business As) or LLC*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Emergency Contact*

PrefixFirst NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Website (if applicable)
License Type (CDL, A, B, C, or Non CDL)*
DOT #*
Motor Carrier - MC #*
SSN/EIN*
Twic Card*

YesNoWorking on it
Endorsements*

(H) Hazmats(N) Tanker(T) Doubles/Triples
Copy of PDF Endorsement Certification and Training Certificates Required*

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Equipment (ALL Equipment Types MUST have their own securements). NOTE: Ask if additional help is needed with securements.*

48' Van/Reefer53' Van/ReeferFlatbedStepdeckHotshot24' Box Truck26' Box TruckOther
Choose All That Apply*

DollyAir RidePallet JackChains/BindersStrapsTarpsLoad LocksLift GatesDock HighPPE Gear
GVWR (Gross Vehicle Weight Rating) Truck + Cargo Weight Total =*
Empty Weight*
ELD Provider*
Truck Information*

Truck #Trailer # (if applicable)
Trailer Length*
Trailer Dimensions (LxWxH)*
For Hotshots; Year, Make, and Model
Max Load Weight (Comments)*
Commodity Types or Restrictions*
What is your Work Preference?*

InTRAstate (Within your state)InTERstate (OTR)
Days you would prefer to drive:*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
Lanes you would prefer to travel (We will discuss further in details during welcome call).*
Cost Per Mile (CPM) - (Total Monthly Expenses /Miles Per Month + Average Cost of 1 Gallon of Fuel/Miles Per Gallon Your Truck Averages = CPM. (Worksheet available if needed)*
Factoring Company (To ensure we only work with Brokers that your company Approves) or N/A if not applicable.*
Factoring Company Agent or N/A if not applicable.*

First NameLast Name
Factoring Company Phone Number or N/A if not applicable.*
Please enter a valid phone number.
Factoring Company Email or N/A if not applicable.*
example@example.com
Website for Factoring Company or N/A if not applicable.*
Insurance Company*
Insurance Agent Email (For Certificate Request)*
Upload Insurance Card With All Policy Information.*

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Please Add Any Other Information You Would Like to Share (Optional).
Solidity Logistics & Planning will require the following documents prior to booking your loads and documents can be uploaded below OR sent via email to Kimberly@SolidityLogistics.com.

1. Completed W-9 Form https://www.irs.gov/pub/irs-pdf/fw9.pdf

2. Copy of Your Motor Carrier Authority Form.

3. Notice of Assignment (If using a Factoring Company)
W-9*

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MC Authority Form*

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Notice of Assignment (If Using Factoring Company)

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Copy of CDL (Front and Back)*

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Upload a Clear Photo So We're able to Put Face to Name.*

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Signature*

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