Company Info
Foreword
Please note, in order to be considered for any new or existing service opportunities, it is critical that the information that you provide within this questionnaire is complete and accurate. Your cooperation and participation are both greatly appreciated.
Carrier General Info
Company Legal Name
*
Company DBA Name (if applicable)
Incorporation / Registration State
--select an item--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Physical Street Address
*
Physical City
*
Physical State/Province
*
Physical Zip/Postal Code
*
Physical Country
*
Company Phone
Company Fax
Company Website
Company Description
Carrier SCAC
*
Carrier MC Number
Carrier DOT Number
Ownership Type (Select all that apply)
(MBE) Minority Business Enterprise
(VBE) Veteran Owned Business Enterprise
(WBE) Woman Business Enterprise
(LGBT) Lesbian, Gay, Bisexual or Transgender
(SD-VOSB) Service Disabled Veteran Owned Small Business
(SB) Small Business
(WOSB) Woman Owned Small Business
(SDB) Small Disadvantaged Business
(HUB Zone) Historically Underutilized Business Zone Business
Primary Contact Info
Primary Contact First Name
Title
Primary Contact Last Name
*
Primary Contact Email
*
Primary Contact Phone
Billing Info
Billing Address Same as Physical?
Yes
Billing Street Address
Billing City
Billing State/Province
Billing Zip/Postal Code
Billing Country
Billing Contact Same As Primary?
Yes
Billing Contact First Name
Title
Billing Contact Last Name
*
Billing Contact Phone
Billing Contact Email
*
Remittance is a Factoring Company or 3rd Party?
Factoring Company Name
Factoring Company Street Address
Factoring Company City
Factoring Company State
Factoring Company Postal Code
Factoring Company Country
Operational Contact Info
Tender Email
*
Spot Quote Contact Name
Spot Quote Phone
Spot Quote Email
RFP Contact Name
RFP Contact Email
Electronic Connection Capabilities
EDI Capabilities
204
210
211
214
856
API Capabilities (Select all that apply)
Rating
Auto-Scheduling
Tracking
Document Retrieval
Modes & Equipment
Carrier Modes
Carrier Type
--select an item--
TL
LTL
Parcel
Carrier Type
*
--select an item--
3PL / Broker
Asset-Based
Asset-Based & 3PL / Broker Hybrid
Freight Forwarder
Modalities (Select all that apply)
*
Auto Hauling
Barge
Cartage: Local Pickup & Deliver
Domestic Intermodal
Expedited Ground
Flat Bed
Full Truckload - 53' Van
Full Truckload - Bulk
Leachate Hauling
MSW Collection
Ocean Container Drayage
Recycle Hauling - Bulk Loose Stream / Commingle
Recycling Collection
Solid Waste Hauling
Warehouse Trans-loading
Warehousing
Number of Drivers
Number of Physical Terminals
Equipment Counts
Day Cab Tractor Unit
Dry Van - 53'
Dry Van - 48'
Side Skirt Trailer
Flatbed Trailer - Standard
Flatbed Trailer - Single Drop (Step Deck)
Flatbed Trailer - Double Drop (RGN)
Private Intermodal Chassis
Tanker Trailer
Frontload Waste & Recycling Collection Truck
Rearload Waste & Recycling Collection Truck
Sideload Waste & Recycling Collection Truck
Rolloff Container Truck
Walking Floor Trailer
Tipper Trailer
End-Dump Trailer
Tow Truck
Auto Hauler - Flat
Auto Hauler - Stacked
Box Truck
Sprinter Van
Other Equipment
Service Area
Service States / Provinces (Select all that apply)
Pacific Region
Alaska
California
Hawaii
Oregon
Washington
Mountain Region
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyomong
Mid-West Region
Illinois
Indiana
Iowa
Kansas
Kentucky
Michigan
Minnesota
Missouri
Nebraska
North Dakota
Oklahoma
South Dakota
Texas
Wisconsin
South East Region
Alabama
Arkansas
Florida
Georgia
Lousiana
Mississippi
Tennessee
Mid-Atlantic Region
Delaware
Maryland
North Carolina
South Carolina
Virginia
Washington DC
West Virginia
North East Region
New Jersey
New York
Ohio
Pennsylvania
New England Region
Connecticut
Maine
Massachusettes
New Hampshire
Rhode Island
Vermont
Canadian Provinces
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Mexican States
Aguascalientes
Baja California
Baja California Sur
Campeche
Chiapas
Chihuahua
Coahuila
Colima
Durango
Guanajuato
Guerrero
Hidalgo
Jalisco
México
Mexico City
Michoacán
Morelos
Nayarit
Nuevo León
Oaxaca
Puebla
Querétaro
Quintana Roo
San Luis Potosí
Sinaloa
Sonora
Tabasco
Tamaulipas
Tlaxcala
Veracruz
Yucatán[g]
Zacatecas
Ocean Container/Drayage
Drayage Cities (Select all that apply)
Drayage Cities (USA)
AK - Anchorage
AL - Birmingham
AL - Huntsville
AL - Mobile
AZ - Phoenix/Tucson
CA - Los Angeles
CA - San Bernardino
CA - San Fran./Oakland
CA - Stockton/Lathrop
CO - Denver
DE - Wilmington, DE
FL - Jacksonville
FL - Miami/Ft.Lauderdale
FL - Panama City
FL - Tampa
FL - Titusville
FL - Winter Haven
GA - Atlanta
GA - Chatsworth/ARP
GA - Cordele
GA - Savannah
HI - Honolulu
IL - Chicago
IL - Decatur
IN - Indianapolis
KY - Georgetown
KY - Louisville
LA - New Orleans
MA - Boston
MA - Springfield
MA - Worcester/Ayer
MD - Baltimore
ME - Portland (Maine)
MI - Detroit
MN - Duluth
MN - Minne/St. Paul
MO - Kansas City
MO - St. Louis
MS - Gulfport
MS - Jackson
NC - Charlotte
NC - Greensboro
NC - Wilmington
ND - Minot
NE - Omaha
NM - Albuquerque
NV - Las Vegas
NV - Reno
NY - Albany
NY - Buffalo
NY - New York City/NJ
NY - Syracuse
OH - Cincinnati
OH - Cleveland
OH - Columbus
OH - Toledo/North Balt.
OR - Portland
PA - Allentown/Beth.
PA - Chambersburg
PA - Harrisburg/Rutherford
PA - Philadelphia
PA - Pittsburgh
PA - Scranton/Taylor
SC - Charleston
SC - Dillon
SC - Greer
TN - Memphis
TN - Nashville
TX - Dallas/Ft. Worth
TX - El Paso
TX - Freeport
TX - Houston
TX - Laredo
TX - Rio Valley/McAllen
TX - San Antonio
UT - Salt Lake City
VA - Front Royal
VA - Norfolk
VA - Richmond
WA - Quincy
WA - Seattle/Tacoma
WA - Spokane
WI - Chippewa Falls
WV - Prichard
Drayage Cities (CAN)
AB - Calgary
AB - Edmonton
BC - Prince George
BC - Prince Rupert
BC - Vancouver
MB - Winnipeg
NB - Moncton / St. John
NS - Halifax
ON - Dryden
ON - Thunder Bay
ON - Toronto
QC - Montreal
SK - Regina
SK - Saskatoon
Drayage Cities (MEX)
EM - Toluca (Puerta Mexico)
GJ - Silao
MX - Mexico (All)
NL - Monterrey / Salinas Victoria
SL - San Luis Potosi (Interpuerto)
Do you Have Heavyweight Permits?
Heavyweight Permit Locations (Select all that apply)
Alabama
Alaska
Arizona
Arkansas
California
CA - Port of Long Beach
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland/Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory