DDT Trucking Services CARRIER SUBMISSION FORM

CARRIER SUBMISSION FORM

Become a DDT Trucking Services Carrier
Today’s Date *
Company Name *
DBA if Applicable
MC#
DOT#*
D-U-N-S #
Contact Name *

First Name Last Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (If different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name & Contact Information for Driver(s) *
Please copy and send Driver Info Form to your drivers so that they can fill in their driver profile.
Available Start Date ? *
Equipment Type

Dry VanFlatbedPower OnlyReefer
Number Of Trucks *
Number Of Drivers Beginning on Available Start Date
Number Of Trailers
Suspension Type*

Air RideLeaf SpringRubber BlockOther
Trailer/Truck Dimensions*
*Specify clearance gate type, dock height, clearance height & width
Truck Posting Info: List Year/Make/Model and Last 6 of VIN *
Preferred Max Weight
Equipment Accessories*

BindersChainsClampsLoad BarsLoad BlockPallet JackRampsStrapsTarpsN/A
Run Preference
Preferred Zones
Preferred Radius
Desired Rate Per Mile
Desired Weekly Gross
Dispatch Service Options*
Max Time Away From Home At One Time?
Can You Provide Pictures Of Your Log, Vehicle Inspection Sheets, & Weight Tickets?
Do You Have A Handsfree Set?
ELD Compliant? (If So, Which Service Provider)
Link to ELD
Authority Letter *

Cancelof
Certificate Of Insurance *

Cancelof
Date of Birth of Primary Policy Holder*

MonthDayYear
Date
Copy Of W-9 (Filled Out & Signed) *

Cancelof
Voided Business Check*

Some Brokers Don't Work With All Factoring Companies. They Will Need A Blank Check For Quick Pay
Cancelof
Notice Of Assignment (If Factoring)

From Your Factoring Company
Cancelof
Name Of Factoring Company (Optional)
Factoring Company Address (Optional)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Factoring Contact Name(Optional)
Contact Number (Optional)
Factoring Submissions Email (Optional)
Is DDT Logistics LLC allowed to book and sign off on loads, on your behalf ? (Yes Or No)*
How Did You Hear About Us ?
Please Take A Moment to Read Terms & Conditions
Limited Power of Attorney Form

BE IT KNOWN, that      Company      with an MC  number of    # , has made and appointed, and by these presents does make and appoint DDT Logistics, LLC true and lawful representative for  , place and stead, for the limited and specific purpose of contracting loads of freight to be hauled by    Company   , giving and granting said DDT Logistics, LLC , full power and authority to do and perform all and every act and thing whatsoever necessary to be done in and about the specific and limited terms (set out herein) as fully, to all intents and purposes, as might or could be done if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that said representative shall lawfully do or cause to be done by virtue thereof.

This power of attorney is to remain in full force and effect until revoked by me in writing. Such revocation is to be mailed to: DDT Logistics, LLC, 27251 Wesley Chapel Blvd, Suite B14 #829, Wesley Chapel, FL 33554.

COMPANY NAME: Company Name              COMPANY NAME: DDT Logistics, LLC
Authorized Signature:   Signature      Authorize Signature: Kelvin Woodson
Printed Name:   First Name   Last Name   Printed Name: Kelvin Woodson
Title:     Title                                   Title: Owner/Managing Partner
Date:    Date*
Signature*

Clear
Print Name *
Title *
Date

MonthDayYear
Date
Please verify that you are human*
info@ddt-logistics.com

Feel free to reach out if you have any questions.
Should be Empty:

CARRIER SUBMISSION FORM

info@ddt-logistics.com