Carrier Set-Up for Dispatch Solutions

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Carrier Set-up

Unlock Your Potential with B-LOADED's Dispatch Solutions

By choosing B-LOADED, you are partnering with a reliable provider of dispatch solutions that prioritize your success as an owner-operator or carrier. Our freight dispatchers are dedicated to identifying the best freight opportunities, negotiating optimal rates, and streamlining your shipment management process. With our extensive network and advanced technology, we ensure that you have the support needed to maximize your efficiency and profitability on the road. B-LOADED is committed to empowering independent truckers with personalized service and resources tailored to your business needs. When you complete the Carrier Set-Up, you unlock access to our comprehensive dispatch services, enabling you to navigate the complexities of the freight industry with ease. Together, we can drive your business forward and create a successful partnership that values your expertise and dedication. Join us in revolutionizing your logistics operations!

Instructions: Please complete the below form by supplying us with all the needed information that pertains to you and your company. The better informed we are, the better we will be able to assist you. This form can be updated at anytime by notifying us. This information is for our internal use only and will not be released to any third party without your expressed written permission.

Finance Application Form

PART I: CARRIER PROFILE INFORMATION SECTION:

MC NUMBER/DOT NUMBER/ INTERSTATE PERMIT

Upload MC#/DOT#

Choose File

IEM/SSN/W-9

Upload IEM/SSN/W-9

Choose File

EIN NUMBER

COMPANY NAME/ D.B.A

Present Address

Street Address

Street Address Line 2

City

State

Zip Code

Country

First Name

Last Name

Office Fax

Cell Number

Office Phone

Website (if applicable)

EMERGENCY CONTACT (FIRST AND LAST NAME)

SCAC CODE

TWIC CERTIFIED

Yes

HAZMAT CERTIFIED

Yes

PRICING

PART II: INSURANCE INFORMATION:

PLEASE NOTE: WE DO REQUIRE OUR CARRIERS TO MAINTAIN A MINIMUM OF $1,000,000 IN LIABILITY INSURANCE AND $100,000 IN CARGO INSURANCE.

INSURANCE COMPANY

INSURANCE CONTACT (FIRST AND LAST NAME)

INSURANCE CONTACT NUMBER

INSURANCE COMPANY EMAIL

INSURANCE COMPANY WEBSITE

PART III: FACTORING INFORMATION:

IF YOU USE A FACTORING SERVICE, PLEASE PROVIDE US WITH THE BELOW INFORMATION. THIS WILL ENSURE THAT WE ONLY USE BROKERS THAT ARE APPROVED BY YOUR FACTORING COMPANY.

FACTORING COMPANY

FACTORING CONTACT (FIRST AND LAST NAME)

FACTORING CONTACT NUMBER

FACTORING COMPANY EMAIL

FACTORING COMPANY WEBSITE

PART IV: EQUIPMENT SECTION:

IF YOU USE A FACTORING SERVICE, PLEASE PROVIDE US WITH THE BELOW INFORMATION. THIS WILL ENSURE THAT WE ONLY USE BROKERS THAT ARE APPROVED BY YOUR FACTORING COMPANY.

TYPE OF EQUIPMENT

NUMBER OF TRUCKS

NUMBER OF DRIVERS

PART V: SERVICE AREAS OF OPERATION

(SELECT ALL THAT APPLY)

UNITED STATES:

CANADA:

RATE OF HAUL INFORMATION:

PLEASE PROVIDE YOUR MINIMUM RATE INFORMATION.

COST PER EXTRA STOP

MAX DROPS

MAX PICKS

MINIMUM RATE PER MILE

DRIVER TOUCH

PART VI: OTHER INFORMATION

PLEASE USE THE FOLLOWING SECTION TO BETTER DESCRIBE YOUR COMPANY. ADDITIONAL INFORMATION WILL HELP US BETTER ASSIST YOUR ORGANIZATION.

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