JBI LOGISTICS LLC Carrier Agreement

JBI LOGISTICS LLC
Carrier Information, Authority & Insurance
CARRIER ONBOARDING
Complete all required fields marked with *
COMPANY INFORMATION
Legal Company Name
DBA / Operating Name
Owner / Primary Contact Name

First NameLast Name
Primary Phone
Format: (000) 000-0000.
Secondary Phone
Format: (000) 000-0000.
Email Address
example@example.com
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years in Operation
How did you hear about JBI?
AUTHORITY & LEGAL
USDOT Number
MC Number
Date Authority Granted

MonthDayYear
Date
INSURANCE | MINIMUM: CARGO $100,000 BI/PD $1,000,000
Insurance Provider Name
Policy Number
Policy Expiration Date

MonthDayYear
Date
Insurance Agent Name / Phone / Email

JBI LOGISTICS LLC
Dispatch Preferences & Document Uploads
CARRIER ONBOARDING
Complete all required fields marked with *
DISPATCH PREFERENCES
Minimum Rate Per Mile ($)
Home Time Frequency
No-Go States & Cities
Do you use a factoring company?
Factoring Company Name (if applicable)
Factoring Contact Name / Phone / Address (if applicable)
NOA on file? Yes or No (if using factoring)
Currently under contract with another Dispatch service? (Yes/ No)
Additional Notes or Special Requirements
DOCUMENT UPLOADS | ACCEPTED: PDF, JPG, PNG · MAX 10MB PER FILE
Attach each required document below. Items marked * must be submitted to complete onboarding.
MC Authority

Cancelof
Federal ID/ Business Entity Document

Cancelof
Insurance Certificate (ACORD/ COI)

Cancelof
Signed W-9

Cancelof
Notice of Assignment (NOA)

Cancelof

JBI LOGISTICS LLC
Payment Agreement
CARRIER ONBOARDING - FORM 1 OF 2
Complete all required fields marked with *
PAYMENT AGREEMENT
Check each box to acknowledge. All boxes must be checked before signing.
Agreed Payment Method
PAYMENT INFORMATION
Zelle: jbidispatch2@gmail.com, Apple Pay: (678) 800-2253, Cash App: $ChasidyFletcher478
Carrier Signature
Date

MonthDayYear
Date
Title
Printed Name
Company Name
JBI LOGISTICS LLC 2321 Sir Barton Way Suite 140 #1054, Lexington, KY 40509
(678) 800-2253 dispatch@jbilogistics.org jbilogistics.org
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