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Dispatch – Carrier Agreement
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Plans and Pricing
Dispatch – Carrier Agreement
Contact
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Dispatcher - Carrier Agreement
What we will need to do business and provide services for your company
Name
Address
Phone Number
Email
How did you hear about us?
Please Select
Facebook
Instagram
LinkedIN
Youtube
Text or Email
Others
MC #
Equipment
Van 53"
Flatbed
Stepdeck or RGN
Hot Shot
Reefer
Box Truck
Power Only
Other
Max Weight Limit
Please list your securements (Tarps, Straps, Chains, lift gate, ramps, etc)
Insurance Information: Your agents PH #, Email (so we are able to attain your COI for your clients/brokers)
Factoring Company Info: Your contacts info, Email and PH # (Please also state how we will vet credit on your clients/brokers) If you do not have a factoring, put N/A.
How often do you want to be home?
What areas will you drive?
Southeast
Midwest
West Coast
North East
Pacific Northwest
Mountain
New York City (check mark if you will drive to this big city)
Chicago IL (check mark if you will drive to this big city)
Will you be willing to recommend us?
Yes
Maybe
No
Please give reference of any two people whom you feel would like our services
Please upload your w9, insurance, authority and Notice of Assignment (of factoring of company if applicable)
Driver's Name, Driver Cell # if you will not be driving
Send
