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Carrier Application
Carrier Application
1
Step 1
Carrier Information
Country
Country
Canada
English
Mexico
Check this box if you’re not a Carrier
I am a freight broker
Legal Name
Company DBA Name
Year of incorporation
date_range
Street Address
City
State / Province / Region
ZIP / Postal Code
First Name
account_circle
Last Name
account_circle
Email
email
Phone
local_phone
Use the same contact information for Remit to Details
Use the same contact information for Remit to Details?
Yes
No
Use the same contact information for Quotes
Use the same contact information for Quotes?
Yes
No
Use the same contact information for Tenders
Use the same contact information for Tenders?
Yes
No
Use the same contact information for Finance
Use the same contact information for Finance?
Yes
No
Use the same contact information for Customer Service
Use the same contact information for Customer Service?
Yes
No
_____________ Remit To ______________
Remit to City
Remit to Street Address
Remit to ZIP / Postal Code
Remit to State / Province / Region
Remit to Contact Name
account_circle
Remit to Contact Email
email
Remit to Contact Phone
local_phone
_____________ Quotes ______________
Quotes City
Quotes Street Address
Quotes ZIP / Postal Code
Quotes State / Province / Region
Quotes Contact Name
account_circle
Quotes Contact Email
email
Quotes Contact Phone
local_phone
_____________ Tenders ______________
Tenders City
Tenders Street Address
Tenders ZIP / Postal Code
Tenders State / Province / Region
Tenders Contact Email
email
Tenders Contact Name
account_circle
Tenders Contact Phone
local_phone
_____ Contact Information for Customer Service ____
Customer Service Contact Phone
local_phone
Customer Service Contact Email
email
_____ Contact Information for Finance ____
Finance Contact Phone
local_phone
Finance Contact Email
email
_____ Additional Information ____
SCAC
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MC#
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DOT#
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Do you own assets under this USDOT/SCAC Code?
Do you own assets under this USDOT/SCAC Code?
Yes
No
HAZMAT Compliance/Dangerous goods
HAZMAT Compliance/Dangerous goods
Yes
No
What is size of your fleet under this Combo? ( Specify power units as well as other assets separately)
Name of your ELD Provider
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Modes Serviced
Less than truckload
Truckload
Air
Ocean
Expedite
Reefer
Flatbed
CTPAT
Document Uploads and Agreement
Insurance Certificate
upload
cloud_upload
Insurance Certificate
Carrier Vetting Process
upload
cloud_upload
Carrier Vetting Process
Workers Compensation
upload
cloud_upload
Workers Compensation
Operating Authority (CVOR Level 2, FMCSA Certificate)
upload
cloud_upload
Operating Authority (CVOR Level 2, FMCSA Certificate)
Overview of the Carrier(Strengths/Coverage areas etc.)
upload
cloud_upload
Overview of the Carrier(Strengths/Coverage areas etc.)
Email
email
Submit
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