Carrier Setup Form
Fields marked with an "*" are required items

Thank you for taking the time to provide your company information so that we will have accurate and current data. If you have trouble with this form, please email: Tracy Ott.

Company Information
Carrier Name:*
Address Line 1:*
Address Line 2:
City:*
State, Province or Territory:*
Postal Code:*
Country:*
Carrier Main Phone Number:*
(Ex: xxx-xxx-xxxx)
 
Time Zone:*
Do you adjust for Daylight Savings Time?*
US DOT Number*
SCAC*(If not available, enter "None")
 
EDI Capable?*
Does your company use LeanLogistics?*
What is the maximum weight (product & pallets) that can be loaded on your dry trailers?
(Enter "N/A" if you have all temp controlled equipment)
What is the maximum weight (product & pallets) that can be loaded on your temp controlled trailers?
(Enter "N/A" if you have all dry equipment)

Operational Contact Information (Dispatch and Customer Service)
Primary Operational Contact Name:*
Primary Operational Contact Title:
Primary Operational Contact Phone:*
(Ex: xxx-xxx-xxxx)
Phone Extension: (if applicable)
Primary Operational Contact Email:*
Primary Operational Contact Fax:*
(Ex: xxx-xxx-xxxx)
Primary Operational Regular Office Hours:*
( ie, 0800 to 1800)		 to
 
Secondary Operational Contact Name:*
Secondary Operational Contact Title:
Secondary Operational Contact Phone:*
(Ex: xxx-xxx-xxxx)
Phone Extension: (if applicable)
Secondary Operational Contact Email:*

After Hours and Emergency Contact information
After Hours Emergency Contact Phone:*
(Ex: xxx-xxx-xxxx)
Phone Extension: (if applicable)
Secondary After Hours Emergency Contact Phone:
(Ex: xxx-xxx-xxxx)
Phone Extension: (if applicable)
After Hours Emergency Contact Hours:
( i.e. 0800 to 1800)		 to

Corporate Contacts/Information
Account Representative (Sales) Contact Name:*
Account Representative (Sales) Contact Title:
Account Representative (Sales) Contact Email:*
Account Representative (Sales) Contact Phone:*
(Ex: xxx-xxx-xxxx)
Phone Extension: (if applicable)
 
Executive Contact Name:
(CEO,COO, President or Owner)
Executive Contact Title:
Executive Contact Email:
Executive Contact Phone:
(Ex: xxx-xxx-xxxx)
Extension: (if applicable)
 
Pricing Contact Name:
Pricing Contact Title:
Pricing Contact Email:
Pricing Contact Phone:
(Ex: xxx-xxx-xxxx)
Extension: (if applicable)

Carrier Terminal Locations: Please complete as City, State
Carrier Terminal Location City State, Province or Territory
Location 1:
Location 2:
Location 3:
Location 4:
Location 5:
Location 6:
Location 7:
Location 8:
Location 9:

Payment Information
Payment Address same as above:
Payment Name:*
Payment Address 1:*
Payment Address 2:
City:*
State, Province or Territory:*
Postal Code:*
Country:*
 
Accounts Receivable Contact Name:*
Accounts Receivable Phone Number:*
(Ex: xxx-xxx-xxxx)
Extension: (if applicable)
Accounts Receivable Contact Email:
Do you want to be paid by check or EFT?:*