Denver Office: 1212 Kerr Gulch Rd. Evergreen, Colorado 80439	Chicago Office: 535 S. Washington Street Naperville, Illinois 60540

Partner Carrier Profile

*Company Name:	________________________________________________________
*Address:	________________________________________________________
*City:	________________________________________________________
*State:	__
*Postal Code:	________________________________________________________
Country:	________________________________________________________
*Phone:	________________________________________________________
Toll Free:	________________________________________________________
Fax:	________________________________________________________
E-mail:	________________________________________________________
Website:	________________________________________________________
Owner / Manager Contact:	________________________________________________________

* MC Number:
* Tax Payer ID:
__Sole Proprieter	__Corporation	__Partnership	__Other

DRIVERS:
Number of Drivers:__
__Company		__Owner Operator
Driver Communication:
__Cell Phone	__Satelite	__Pager	__Check-Call
__Other: ______________________

EQUIPMENT TYPE:

Please fill in quantity for each if applicable:

__Tractors	__Flatbeds	__Single Dropdecks
__Double Dropdecks	__Detachable Double Drops	__Multi-Axle Dropdecks
__Single Dropdecks	__Vans	__Sidekit Flatbed
__Connestoga Flatbed	__Curtainside Flatbed	__ other ___________

INSURANCE:
Cargo Insurance $ Coverage	_______________________________________________
Liability Insurance $Coverage	______________________
Agency Name: ___________________	Phone: __________

PREFERENCES:
Do you haul?	__Local __Regional __National
Do you haul Flat/Step LTL?	__Yes __No
Do you haul over-size, overweight shipments often? __Yes __No
Do you haul to Canada? __Yes __No
Do you allow your trailers in Mexico? __Yes __No
States/Regions you won't run? __
States/Regions where you need freight? __