Carrier Profile Form

Join our network of trusted carriers and become part of the TRex Prime family.

Carrier Name *

USDOT# *

MC Number *

Tax ID Number *

State of Incorporation *

Fax

Phone Number *

Main Email *

Carrier Address *

City *

State *

ZIP Code *

Dispatch Contact Name *

Dispatch Email *

Dispatch Phone *

Accounting Contact Name *

Accounting Email *

Accounting Phone *

Our Company uses a factoring company:

Yes

Regular: 30 days after receipt of POD and invoice.

7 day Quick-pay: 3% less in 7 days.

1 day Quick-pay: (5% + $20) less in 1 day.

Operating Areas / Notes

Name *

Title *

E-mail Address *

Agreement Date *

W9 Document (PDF) *

COI (Certificate of Insurance) *