Home
About Us
Services
Carrier Profile
Contact Us

CARRIER PROFILE

Once you complete the carrier profile below, we will email you a Dispatch Service Agreement along with a General Power Of Attorney (Agent). Don’t forget to attach your MC Authority, W9 & Insurance below!

Company Name *

DBA (IF ANY)

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

MC# *

USDOT# *

FEIN/SSN *

Number of Trucks

Number of drivers

Select your carrier

Flatbed
Power Only
Reefer
Van

Do you factor your invoices* *

Yes
No

Upload MC Authority Letter

Click or drag a file to this area to upload.

Upload Liability Insurance

Click or drag a file to this area to upload.

Upload W9 form

Click or drag a file to this area to upload.

What states do you prefer to drive? (Choose all that apply)

Region 1 • Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
Region 2 • New Jersey, New York
Region 3 • Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia
Region 4 • Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee
Region 5 • Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
Region 6 • Arkansas, Louisiana, New Mexico, Oklahoma, Texas
Region 7 • Iowa, Kansas, Missouri, Nebraska
Region 8 • Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming
Region 9 • Arizona, California, Nevada
Region 10 • Idaho, Oregon, Washington
Canada • Alberta, British Columbia, Manitoba, Ontario, Quebec
Mexico

What states would you not like to drive in?

Subscribe To Us

Email *

CARRIER PROFILE

Subscribe To Us

Copyright 2022, A & D DISPATCH & LOGISTICS