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Carrier Profile 

Instructions: Please complete this form giving us all the information that pertains to you and your company. The better informed we are the better we will be able to assist you. This form should be updated at any time by notifying us. This information is for our use only and will not be released to any third party without your express written permission.

Part 1: Carrier Information Section

Part 2: Equipment Types

Number and Type of Trucks:

PLEASE LIST THE BROKERS THAT YOU ARE ALREADY SET UP/APPROVED WITH BELOW:

Dispatch Specifications

Please give us your minimum cents per mile information. We understand that many factors will change this 
information, but this will give us a starting point.

Driver Touch
Mountains?
Endorsements?
Tolls?

Areas of USA you like to travel (ZONES) – Please circle all that apply

Northeast
Midwest
South
West

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Note:  When returning the Dispatcher Packet, which includes the completed Dispatcher Agreement, this Carrier
Profile and the Limited Power of Attorney, please include COPIES of the MC Authority Letter (Certificate), Certificate
of Insurance (C.O.I.), and W9. If you are working with a factoring company, please also include a copy of their credit
application so that we can run the credit on the brokers for you on your behalf. Thank you.

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