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THE RIGHT PARTNERSHIP: Tell us about yourself
Full Name
*
Phone
*
Email Address
*
Company
MC#
*
How long have you had your authority?
*
DOT#
Preferred Lanes
Insurance Company – Agent / Contact Info
Factoring Company – Agent / Contact Info
THE RIGHT EQUIPMENT: Tell us about what you operate
Truck Type – Select all that apply
*
Van
Flatbed
Reefer
Box Truck
Hot Shot
Other
Truck Length
Truck Width
Truck Height
Trailer #
Equipment – Select all that apply
Lift Gate
Securement Equipment (box trucks / flatbeds)
Tarps (required for flatbeds)
Dolly
Pallet Jack
PPE Gear
SUBMIT
Full Name
Phone
Email Address
Company
MC#
How long have you had your authority?
DOT#
Preferred Lanes
Insurance Company
Factoring Company
THE RIGHT EQUIPMENT: Tell us about what you operate
SUBMIT
THE RIGHT EQUIPMENT: Tell us about what you operate
TRUCK TYPE
a. Van
b. Flatbed
c. Reefer
d. Box Truck
e. Hot Shot
EQUIPMENT (select all the apply)
a. Lift Gate
b. Securement Equipment (box trucks / flatbeds)
c. Tarps (required for flatbeds)
d. Dolly
e. Pallet Jack
f. PPE Gear
Trailer Length
Trailer Width
Trailer Height
Trailer #
SUBMIT